超声对肠梗阻的诊断体会

Experience of ultrasonic diagnosis of intestinal obstruction

目的:探讨超声在诊断肠梗阻临床价值。方法:2013年2月-2014年6月收治肠梗阻患者60例,所有患者均采用彩色多普勒进行检查。结果:所有患者均明确诊断为肠梗阻,小肠梗阻21例(35.0%),其中手术后粘连7例(33.3%),阑尾炎及其周围炎14例(66.7%);结肠梗阻39例(65.0%),其中肠套叠、肠扭转17例(45.6%),肠内粪石9例(23.1%),结肠肿瘤13例(33.3%)。彩色多普勒超声图像表现:结肠扩张>6 cm,小肠梗阻表现为小肠扩张,一般>3cm,肠腔内有较强的气体回声及杂乱光点,肠腔内积气,管腔明显扩张,表现为肠壁变薄,梗阻处肠黏膜水肿表现为肠壁增厚,腹腔内可见液性暗区,肠套叠时表现为"套筒征"、"同心圆征"等多条线状稍强回声;肠肿瘤时则表现为"靶环征"或"假肾征"等。结论:彩色多普勒在诊断肠梗阻时具有可操作性强、操作简单、图像清晰、易于诊断、患者无痛苦等优点,值得临床推广。

Objective:To investigate the clinical value of echocardiography in the diagnosis of intestinal obstruction.Methods:60cases with intestinal obstruction were selected from February 2013 to June 2014.All cases were examined by color doppler.Results:All cases were diagnosed as intestinal obstruction.Intestinal obstruction in 21 cases(35%),wherein the adhesion in 7 cases after the operation(33.3%),14 cases of appendicitis and its surrounding inflammation(66.7%);colonic obstruction in 39 cases(65%),including 17 cases of intussusception,volvulus(45.6%),9 cases of intestinal bezoars(23.1%),colon tumor in 13 cases(33.3%).Color doppler ultrasound image manifestations:dilatation of the colon was>6 cm.Small bowel obstruction was dilated small bowel,general>3 cm.There was a strong gas echo and messy spot in the intestinal lumen,intestinal cavity pneumatosis,lumen expanding significantly,which showed the intestinal wall became thinner,intestinal mucosal edema at the obstruction showed intestinal wall thickening.We could see liquid dark area in intraperitoneal,and the intussusception showed as 'sleeve sign', 'concentric circle sign' and many other linear stronger echo.The intestinal tumors showed 'target sign' or 'pseudokidney sign' and so on.Conclusion:Thr color doppler has the advantages of strong operability,simple operation,clear image in the diagnosis of intestinal obstruction,easy diagnosis,painless for patients and others,so it is worthy of clinical promotion.