缺血性肠病患者的腹部CT影像及诊断价值分析

Analysis of The Characteristics and Clinical Diagnostic Value of Abdominal CT Imaging in Patients with Ischemic Bowel Disease

目的:初步了解腹部CT检测下缺血性肠病呈现的影响学特点以及该检测方式的临床诊断价值。方法:将42例于2015年10月至2018年10月期间确诊为缺血性肠病的患者作为主要研究对象,通过腹部CT影像学检测的方式对其病因进行检测,并对不同结局的患者CT影像学差异进行分析。结果:缺血性肠病患者的病因类型相对较多,CT影像学检测主要表现为机体出现腹腔积液与游离气体、门静脉积气、肠管扩张与肠壁增厚或者肠梗阻等多类异常性的变化。通过对两组不同结局缺血性肠病患者腹腔积液与游离气体以及肠壁气体和门静脉积气等情况进行调查分析发现,死亡组的发生率分别为66.7%和33.3%与54.2%以及45.8%,而生存组分别为27.8%和0.0%与11.1%以及5.6%。统计学分析发现p<0.05,即相关差异具有统计学意义。结论:缺血性肠病患者并不存在特异性的特点,因而临床实践中存在一定的漏诊与误诊的概率。该病患者经由腹部CT影像学检测发现,其存在腹腔积液与游离气体以及肠壁气体和门静脉积气等情况,而上述情况与患者的预后具有一定的相关性。

Objective:To investigate the clinical diagnostic value and clinical characteristics of abdominal CT in the diagnosis of ischemic bowel disease.Methods:42 patients diagnosed with ischemic bowel disease from October 2015 to October 2018 were chosen as the main research subjects. The etiology was examined by means of abdominal CT imaging, and CT imaging differences of different outcomes were analyzed.Results:The etiology types of ischemic bowel disease were relatively numerous, and CT imaging showed that there were many kinds of abnormal changes such as peritoneal effusion and free gas, portal venous effusion, intestinal tube dilation and intestinal wall thickening or intestinal obstruction. Through the investigation and analysis of peritoneal effusion and free gas as well as intestinal wall gas and portal vein gas in two groups of patients with ischemic bowel disease with different outcomes, the incidence rates of death were 66.7 %, 33.3 % and 54.2 % and 45.8 %, respectively. The survival groups were 27.8 %, 0.0 %, 11.1 % and 5.6 %, respectively. Statistical analysis found that p<0.05, that is, the relevant difference is statistically significant.Conclusion:There is no specific characteristics in patients with ischemic bowel disease, so there is a certain probability of missed diagnosis and misdiagnosis in clinical practice. The patients with the disease were found to have abdominal effusion and free gas as well as intestinal wall gas and portal vein gas via abdominal CT imaging, and the above conditions have a certain correlation with the prognosis of the patients.