临床不典型中孕期急性阑尾炎患者的超声诊断分析

Ultrasonographic diagnosis of acute appendicitis during atypical middle pregnancy

目的总结临床不典型中孕期急性阑尾炎超声声像图特征及探讨如何提高中孕期阑尾炎的检出率。方法对23例于2014年8月至2017年3月在徐州市中心医院超声检查并经手术及病理检查证实为急性阑尾炎孕妇的超声声像图特征进行总结,并结合每例超声检查过程进行分析。结果 23例孕妇阑尾炎术前超声与手术结果诊断一致。23例孕妇阑尾炎超声声像图表现包括:直径超过7 mm、管壁回声减低、张力高、周边高回声包绕。6例孕妇炎性阑尾呈节段性肿大,4例孕妇阑尾内示粪石阻塞,无穿孔及周围脓肿案例。14例孕妇行左侧卧位、5例孕妇嘱其排空膀胱后成功探查到炎性阑尾。8例孕妇探查阑尾耗时6 min,余探查平均用时4 min。单用腹部凸阵探头、线阵探头、腔内凸阵探头炎性阑尾的检出率分别为69.6%、39.1%、82.6%,三种探头联合应用炎性阑尾的检出率为100%。结论腔内凸阵探头对于临床不典型中孕期急性阑尾炎检出率具有相对优势。三种探头联合应用可以显著提高炎性阑尾检出率,对临床治疗起到重要参考价值。

ObjectiveTo summarize the ultrasonographic features of acute appendicitis in the diagnosis of acute appendicitis during the second trimester of pregnancy.MethodsFrom August 2014 to March 2017 in our hospital,we summarized ultrasonographic features on 23 cases of acute appendicitis pregnant women who confirmed by ultrasound,surgery and pathological examination.ResultsIn preoperation,the ultrasound diagnosis and surgical results were consistent on 23 cases of pregnant women with appendicitis.23 cases of pregnant women with appendicitis sonographic manifestations included:the diameter of more than 7mm,the wall echo reduction,high tension,peripheral high echo wrap.6 cases of pregnant women with segmental inflammation of the appendix,4 cases of pregnant women with obstruction of the appendix,none case of perforation and abscess.14 cases of pregnant women underwent left lateral decubitus,and 5 cases of pregnant women who were told to drain the bladder were successfully detected.8 cases of pregnant women took about 6 minute to explore the appendix,while the average time spent on the exploration was 4 minutes.The detection rate was 69.6%,39.1%,and 82.6%respectively,with the abdominal convex array probe,linear array probe,and convex array probe singly.The detection rate was 100%if three kinds of probes were joint used on inflammatory appendix.ConclusionThe intracavity convex array probe has relative advantages for the detection of acute appendicitis in clinical atypical middle pregnancy.The combination of three probes can significantly improve the detection rate of inflammatory appendix,and play an important reference value for clinical treatment.