彩色多普勒超声在腹外疝鉴别诊断中的研究

Sensitivity and specificity of color Doppler ultrasound in the differential diagnosis of external abdominal external hernia

目的探讨腹外疝鉴别诊断中彩色多普勒超声的应用效果,初步分析诊断的敏感性与特异性。方法回顾性分析2017年1月至2019年8月皖南医学院第二附属医院超声科接诊的77例拟诊断为腹外疝患者的信息。全部患者均接受彩色多普勒超声检查、手术探查,分析彩色多普勒超声对腹外疝的诊断价值。结果77例患者中,男性65例,女性12例,平均年龄(61.66±13.81)岁,平均病程(3.02±0.86)个月。经过手术探查,共有74例确诊为腹外疝,其中斜疝67例,直疝5例,股疝1例,半月线疝1例。利用彩色多普勒超声共诊断出病灶107个,2例腹股沟斜疝出现误诊,误诊为脂肪瘤和淋巴结肿大,发生1例漏诊。彩色多普勒超声对腹外疝的诊断敏感度为96.10%,诊断特异度为100%,诊断准确度为97.29%,阳性预测值为95.94%,阴性预测值为100%,彩色多普勒超声与手术两种诊断方法的Kappa值为0.736。结论彩色多普勒超声在腹外疝的鉴别诊断中,具有良好的准确性,实际工作中需结合影像学结果、临床表现等综合考虑,为术前诊断提供良好的参考依据。

Objective To explore the application effect of color Doppler ultrasound in the differential diagnosis of abdominal external hernia,and to analyze the sensitivity and specificity of diagnosis.Methods A retrospective analysis of the information of 107 patients who were to be diagnosed as abdominal external hernias admitted to the ultrasound department of the Second Affiliated Hospital of Wannan Medical College from January 2017 to August 2019.All patients underwent color Doppler ultrasound examination and operation,to analysis of the value of color Doppler ultrasound in the diagnosis of abdominal external hernia.Results Among the patients,99 were males and 8 were females,with an average age of(61.40±13.81)years and an average course of(3.02±0.86)months.After surgical exploration,a total of 101 cases were diagnosed as abdominal external hernias,including 67 cases of indirect inguinal hernia,30 cases of direct hernia,3 cases of femoral hernia,and 1 case of spigelian hernia.A total of 107 lesions were diagnosed by color Doppler ultrasound.2 cases of inguinal hernia were misdiagnosed as lipoma and lymphadenopathy,and 1 case was missed.The diagnostic sensitivity of color Doppler ultrasound for abdominal external hernia is 94.39%,the diagnostic specificity is 83.33%,the diagnostic accuracy is 97.03%,the positive predictive value is 99.01%,and the negative predictive value is 85.71%.The Kappa value of the two diagnostic methods between color Doppler ultrasound and surgery is 0.736.Conclusion Color Doppler ultrasound has good accuracy in the differential diagnosis of abdominal external hernia.In practical work,comprehensive considerations such as imaging results and clinical manifestations should be combined to provide a good reference for preoperative diagnosis.