开放腹股沟疝无张力修补术后补片感染B超和CT联合诊断的应用价值

The value of combined ultrasound and CT diagnosis of mesh infection after the open tensionfree repair of inguinal hernia

目的探讨开放式腹股沟疝无张力修补术后补片感染B超和CT联合诊断的应用价值。方法开放式腹股沟疝无张力修补术后确诊补片感染病人83例,术前均行B超和腹部CT检查,且以术中证实为确诊标准,比较B超、CT及其联合检查对开放式腹股沟疝无张力修补术后补片感染的诊断价值。结果83例病人中,B超诊断补片感染符合率75.90%(63/83);CT诊断补片感染符合率为86.74%(72/83),B超联合CT诊断诊断补片感染符合率为87.95%(73/83)。B超、CT、B超联合CT预判补片感染深度与手术中证实结果相比的准确度、灵敏度、特异度、Kappa值分别为88.76%、75.73%、90.58%、0.695;91.16%、80.96%、93.06%、0.774;91.97%、83.52%、93.64%、0.795。联合检查对诊断开放式腹股沟疝无张力修补术术后补片感染的应用价值优于单独超声检查和单独CT检查,差异有统计学意义(P<0.05)。结论B超联合CT诊断开放式腹股沟疝无张力修补术后补片感染的应用价值优于单独超声检查和单独CT检查。

Objective To investigate the application value of combined ultrasound and CT diagnosis of mesh infection after open inguinal hernia tensionless repair.Methods 83 patients admitted to our hospital with confirmed patch infection after tension-free repair of open inguinal hernia were studied,all of whom underwent preoperative ultrasound and abdominal CT examination,and intraoperative confirmation was the diagnostic criteria.To compare the value of ultrasonography,CT and combined examination in the diagnosis of mesh infection after open tension-free inguinal hernia repair.Results Among the 83 patients,the compliance rate of ultrasound diagnosis of mesh infection was 75.90%(63/83 cases);the compliance rate of CT diagnosis of mesh infection was 86.74%(72/83 cases);and the compliance rate of ultrasound combined with CT diagnosis of mesh infection was 87.95%(73/83 cases).The accuracy,sensitivity,specificity,and kappa values of ultrasound,CT,and ultrasound combined with CT in predicting the depth of mesh infection compared with the results confirmed during surgery were 88.76%,75.73%,90.58%,and 0.695;91.16%,80.96%,93.06%,and 0.774;and 91.97%,83.52%,93.64%,and 0.795.The combined examination was better than ultrasonography alone and CT alone in the diagnosis of postoperative mesh infection after open inguinal hernia repair(P<0.05).Conclusion Ultrasound combined with CT is better than ultrasound alone and CT alone in diagnosing mesh infection after open inguinal hernia repair without tension.