超声诊断重度脂肪肝患者胆囊结石的误诊影响因素分析

Factors influencing misdiagnosis of cholecystolithiasis in patients with severe fatty liver diagnosed by ultrasound

目的研究超声诊断重度脂肪肝患者胆囊结石的误诊影响因素。方法选择2016年9月至2018年3月本院接诊的130例重度脂肪肝合并胆结石的患者进行研究。所有患者均使用彩色多普勒超声仪器进行检查,结合超声诊断结果经过手术后进行病理结果诊断,对准确率与误诊率进行计算,并对相关影响因素进行分析。结果使用超声对130例患者进行检查,术后证实胆结石患者有123例,准确率为94.62%,误诊率为5.38%。其中泥沙样胆结石的诊断准确率明显低于其他类型,差异有统计学意义(P<0.05)。年龄在40～60岁的患者的发病率明显高于其他年龄阶段,差异有统计学意义(P<0.05)。男性中胆结石的发生率明显低于女性患者的胆结石发病率,差异有统计学意义(P<0.05)。结论采用超声对重度脂肪肝患者胆结石情况进行检查时应该尽量避免客观因素的影响,在一定的程度上降低误诊率为临床检查提供更加客观的依据。

Objective To study the factors influencing the misdiagnosis of cholecystolithiasis by ultrasound in patients with severe fatty liver.Methods A total of 130 patients with severe fatty liver and cholecystolithiasis were admitted to our hospital from September 2016 to March 2018.All the patients were examined by color Doppler ultrasound, and the pathological results were diagnosed by ultrasonic diagnosis after operation. The accuracy rate and misdiagnosis rate were calculated, and the related influencing factors were analyzed. Results 130 patients were examined by ultrasound. 123 cases of gallstones were confirmed after operation, the accuracy rate was 94.62%, and the misdiagnosis rate was 5.38%. The diagnostic accuracy of sediment like gallstones was significantly lower than that of other types(P<0.05). The incidence of age at 40-60 years of age was significantly higher than that of other age groups, and the difference was statistically significant(P<0.05). The incidence of gallstones in males was significantly lower than that in female patients, and the difference was statistically significant(P<0.05). Conclusion It is necessary to avoid the influence of objective factors and to reduce the rate of misdiagnosis to provide more objective basis for clinical examination by using ultrasound to check the cholecystolithiasis in patients with severe fatty liver.