B超检查在不同类型急性阑尾炎诊断中的应用价值

Application Value of B-ultrasound Examination in the Diagnosis of Different Types of Acute Appendicitis

目的研究B超检查在不同类型急性阑尾炎诊断中的应用价值。方法选取2017年1月-2019年12月在我院诊治的62例急性阑尾炎患者为研究对象,分析病理诊断结果,比较不同类型急性阑尾炎诊断准确率、误诊率、漏诊率,不同类型阑尾炎特征、不同类型阑尾影像学特征。结果手术病理确诊62例急性阑尾炎患者中,单纯性阑尾炎18例,化脓性阑尾炎28例,坏疽性阑尾炎8例,阑尾周围脓肿8例;B超检查诊断率为87.10%;单纯性阑尾炎诊断准确率低于化脓性阑尾炎、坏疽性阑尾炎、阑尾周围脓肿(P<0.05),误诊率、漏诊率比较(P>0.05);单纯性阑尾炎、化脓性阑尾炎、坏疽性以及阑尾周围脓肿阑尾炎阑尾长度比较(P>0.05);化脓性阑尾炎、坏疽性阑尾炎、阑尾周围脓肿阑尾炎患者阑尾宽度、管壁厚度均大于单纯性阑尾炎患者(P<0.05);化脓性阑尾炎、坏疽性阑尾炎淋巴结肿大、腹腔积液、管腔扩张及管壁层次不清均高于单纯性阑尾炎、阑尾周围脓肿(P<0.05),管腔内强回声、不规则包块比较(P>0.05)。结论B超检查在不同类型急性阑尾炎诊断中具有重要的价值,可明确不同类型急性阑尾炎超声征象特点,促进不同类型的有效鉴别,减小漏诊和误诊率。

Objective To study the application value of B-ultrasound in the diagnosis of different types of acute appendicitis.Methods A total of 62 patients with acute appendicitis who were treated in our hospital from January 2017 to December 2019 were selected as the research objects.The pathological diagnosis results were analyzed.The diagnostic accuracy,misdiagnosis rate,missed diagnosis rate,characteristics of different types of appendicitis and imaging characteristics of different types of appendix were compared.Results Among the 62 patients with acute appendicitis confirmed by surgery and pathology,18 cases were simple appendicitis,28 cases were suppurative appendicitis,8 cases were gangrenous appendicitis,and 8 cases were periappendiceal abscess;the diagnostic rate of B-ultrasound was 87.10%.The diagnostic accuracy of simple appendicitis was lower than that of suppurative appendicitis,gangrenous appendicitis and periappendiceal abscess(P<0.05),there was no significant difference in misdiagnosis rate and missed diagnosis rate in simple appendicitis,suppurative appendicitis,gangrenous appendicitis,periappendiceal abscess(P>0.05).There was no significant difference in the length of appendix between simple appendicitis,suppurative appendicitis,gangrenous appendicitis and appendicitis with periappendiceal abscess(P>0.05).The width and wall thickness of appendix in patients with suppurative appendicitis,gangrenous appendicitis and periappendiceal abscess appendicitis were greater than those in patients with simple appendicitis(P<0.05).Lymphadenectasis,peritoneal effusion,lumen dilatation and wall unclearness of purulent appendicitis and gangrenous appendicitis were higher than those of simple appendicitis and periappendiceal abscess(P<0.05).There was no significant difference in the strong echo and irregular mass in the lumen of suppurative appendicitis,gangrenous appendicitis,simple appendicitis and periappendiceal abscess(P>0.05).Conclusion B-ultrasound examination has important value in the diagnosis of different types of acute appendicitis,which can clarify the characteristics of ultrasonic signs of different types of acute appendicitis,promote the effective identification of different types,reduce the rate of missed diagnosis and misdiagnosis.