螺旋CT、钡餐造影及X线在老年性食管裂孔疝诊断中的应用价值

Application value of spiral CT, barium meal angiography and X-ray in the diagnosis of senile hiatal hernia

目的研究螺旋CT、钡餐造影及X线在老年性食管裂孔疝诊断中的应用价值。方法选取2014年1月至2018年6月入院的82例疑似老年性食管裂孔疝患者为研究对象,所有患者均选用螺旋CT、钡餐造影及X线进行检查,以手术病理结果为诊断金标准,对比X线、钡餐造影及螺旋CT的诊断结果。结果 82例疑似老年性食管裂孔疝患者中,经手术病理检查显示66例(80.49%)阳性,16例(19.51%)阴性(3例左下肺脓肿、1例纵膈肿瘤、2例贲门癌、10例冠心病)。螺旋CT与钡餐造影检查的诊断阳性率比较,差异无统计学意义(P>0.05);螺旋CT及钡餐造影检查的诊断阳性率显著高于X线,差异具有统计学意义(P<0.05)。螺旋CT、钡餐造影检查的灵敏度、特异度及准确度均显著高于X线,差异有统计学意义(P<0.05);螺旋CT与钡餐造影检查的灵敏度、特异度及准确度比较,差异无统计学意义(P>0.05)。结论 X线检查方式应用于老年性食管裂孔疝诊断中具有操作简便等优点,但是诊断阳性率、灵敏度、特异度及准确度均较低,而钡餐造影、螺旋CT的诊断阳性率、灵敏度、特异度及准确度较高,但钡餐造影检查方式的操作难度较大。因而,临床诊断时应根据患者的实际情况选用相应的诊断方式。

Objective To study the application value of spiral CT,barium meal angiography and X-ray in the diagnosis of senile hiatal hernia.Methods Eighty-two patients with suspected senile hiatal hernia admitted from January2014to June2018were selected as the study objects.All patients were examined by spiral CT,barium meal radiography and X-ray.The diagnostic gold standard was the result of surgical pathology.The diagnostic results of X-ray,barium meal radiography and spiral CT were compared.Results Of82elderly patients with suspected hiatal hernia,66cases(80.49%)were positive and16cases(19.51%)were negative(3cases of left lower lung abscess,1case of mediastinal tumors,2cases of cardiac cancer and10cases of coronary heart disease).There was no significant difference in the positive diagnostic rates between spiral CT and barium meal radiography(P>0.05).The positive diagnostic rates of spiral CT and barium meal radiography were significantly higher than that of X-ray,the differences were statistically significant(P<0.05).The sensitivity,specificity and accuracy of spiral CT and barium meal radiography were significantly higher than those of X-ray,the differences were statistically significant(P<0.05).There were no significant differences in sensitivity,specificity and accuracy between spiral CT and barium meal radiography(P>0.05).Conclusion X-ray examination has the advantages of simple operation in the diagnosis of senile esophageal hiatal hernia,but the positive diagnostic rate,sensitivity,specificity and accuracy of diagnosis are lower,while barium meal radiography and spiral CT have higher positive diagnostic rate,sensitivity,specificity and accuracy,but barium meal radiography is more difficult to operate.Therefore,clinical diagnosis should be based on the actual situation of patients to choose the appropriate diagnostic methods.