实时超声对急性阑尾炎的早期诊断价值新探

The value of early diagnosis in acute appendicitis by using ultrasound

目的 旨在探讨B超对具不典型症状的急性阑尾炎的早期诊断价值。方法 在右腹部进行多切面扫查,局部加压,寻找病变阑尾并观察周围组织记录声像特征。结果 病变阑尾管壁之各层结构声像特征为:阑尾管腔内径扩大,管壁增厚。经与手术结果对照发现:管壁增厚在急性单纯性阑尾炎中以粘膜层增厚为主;化脓性阑尾炎中以浆膜层为主;坏疽性阑尾炎表现为全层不规则增厚。结论 超声检查可显示阑尾炎的直接征象,不同类型的阑尾超声声像图变化反应了阑尾炎的病理改变。当临床高度怀疑急性阑尾炎,而正常部位扫查不能显示时,应根据解剖特点,遵循阑尾炎的病理发展过程进行细致现察,是早期诊断与鉴别诊断的关键。

Purpose The purpose of this study was to consider the value of early diagnosis in acute appendicitis of atypical symptoms by ultrasonic examination. Methods The patients were examined by moving the probe up and down on the right abdomen, then applying pressure and looking for the focal s appendix. We observed the peripheral tissue and recorded the image characteristics. Results The different layer structures of the vessel wall of the focal's appendix have different image characterists. The vessel interior diameter had expanded. The vessel wall became thickened. In contrast to the surgical result, it could be revaled that the vessed wall became thickened in acute simple appendicitis and it was dominated by mucous. In aucte suppurative appendicitis, it was dominated by tunica serosa,and in acute gangrenous appendicitis, it was dominated by an all round thicken irregularity. Conculsion With ultrasonic examination , the appendix can clearly be seen. The changes in the ultrasonic images in different types of appendix mirrors appendicitis is doubted by clinical staff and can't be detected in the normal location, it must be investigated according to the anatomical charactoristics. It is important to carefully observe the appendicitis pathologic process. These are a key to early diagnosis and differential diagnosis.