腹部CT在急性阑尾炎诊断治疗中的积极意义和诊断要点探讨
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摘要
目的:探讨腹部CT在急性阑尾炎诊治中的临床意义及其诊断要点。方法:回顾性分析我院2016年2月至2017年10月接受影像学检查及手术治疗的66例急性阑尾炎患者的临床资料,均采用腹部CT和超声检查进行临床诊断,以术后病理诊断结果为参照标准,比较腹部CT与超声诊断急性阑尾炎的检查情况。结果:腹部CT诊断蜂窝织炎性阑尾炎32例,水肿性阑尾炎19例,坏疸性阑尾炎13例,诊断符合率为96. 7%;超声诊断蜂窝织炎性阑尾炎29例,水肿性阑尾炎15例,坏疸性阑尾炎12例,诊断符合率为84. 8%;与超声诊断相比,腹部CT诊断急性阑尾炎的符合率较高(P <0. 05)。结论:腹部CT检查是诊断急性阑尾炎的理想方法,其诊断符合率及病理分型的准确性高于超声检查,且在急性阑尾炎的诊断治疗中发挥着重要作用,值得临床应用及推广。
Objective: To investigate the clinical significance and diagnostic criteria of abdominal CT in the diagnosis and treatment of acute appendicitis. Methods: The clinical data of 66 patients with acute appendicitis who underwent imaging examination and surgical treatment from February 2016 to October 2017 in our hospital were retrospectively analyzed.All patients underwent abdominal CT and ultrasonography for clinical diagnosis. For the reference standard,the comparison of abdominal CT and ultrasound in the diagnosis of acute appendicitis was compared. Results: Abdominal CT diagnosed 32 cases of cellulitis inflammatory appendicitis,19 cases of edematous appendicitis,13 cases of gangrenous appendicitis,the diagnostic coincidence rate was 96. 7%; ultrasound diagnosis of cellulitis inflammatory appendicitis in 29 cases,edematous appendicitis in 15 cases,bad 12 cases of spastic appendicitis,the diagnostic coincidence rate was 84. 8%; compared with ultrasound diagnosis,the coincidence rate of abdominal CT diagnosis of acute appendicitis was higher( P < 0. 05). Conclusion: Abdominal CT examination is an ideal method for diagnosing acute appendicitis. The diagnostic accuracy and pathological classification are more accurate than ultrasonography,and it plays an important role in the diagnosis and treatment of acute appendicitis. It is worthy of clinical application and promotion.
Objective: To investigate the clinical significance and diagnostic criteria of abdominal CT in the diagnosis and treatment of acute appendicitis. Methods: The clinical data of 66 patients with acute appendicitis who underwent imaging examination and surgical treatment from February 2016 to October 2017 in our hospital were retrospectively analyzed.All patients underwent abdominal CT and ultrasonography for clinical diagnosis. For the reference standard,the comparison of abdominal CT and ultrasound in the diagnosis of acute appendicitis was compared. Results: Abdominal CT diagnosed 32 cases of cellulitis inflammatory appendicitis,19 cases of edematous appendicitis,13 cases of gangrenous appendicitis,the diagnostic coincidence rate was 96. 7%; ultrasound diagnosis of cellulitis inflammatory appendicitis in 29 cases,edematous appendicitis in 15 cases,bad 12 cases of spastic appendicitis,the diagnostic coincidence rate was 84. 8%; compared with ultrasound diagnosis,the coincidence rate of abdominal CT diagnosis of acute appendicitis was higher( P < 0. 05). Conclusion: Abdominal CT examination is an ideal method for diagnosing acute appendicitis. The diagnostic accuracy and pathological classification are more accurate than ultrasonography,and it plays an important role in the diagnosis and treatment of acute appendicitis. It is worthy of clinical application and promotion.
引文
1蒋忠毅.16层螺旋CT与高频彩超在非典型急性阑尾炎诊断中的应用价值比较[J].临床合理用药杂志,2016,9(15):159-160.
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3刘新爱,王同明,任月勤.三种病理类型急性阑尾炎患者的临床体征及多层螺旋CT征象特点差异性分析[J].中国CT和MRI杂志,2017,15(08):124-127.
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5唐剑辉,李光明,曾军.改良Alvarado评分系统结合多层螺旋CT在诊断急性阑尾炎方面的临床价值研究[J].中华临床医师杂志(电子版),2016,10(10):1427-1431.
6李光明,李智锋,孙小会,等.多层螺旋CT征象诊断急性阑尾炎病理类型的价值[J].中国医学影像学杂志,2016,24(06):451-454.
7杨家辉,毛巨江,崔冬冰,等.多层螺旋CT对急性阑尾炎及其并发症的诊断价值[J].贵州医科大学学报,2017,42(11):1349-1352.
8杨峰,周静然,赵传军.基于腹部横截面积的低剂量CT扫描诊断急性阑尾炎的可行性[J].中国介入影像与治疗学,2016,13(05):302-305.
2刘洪,高靳,周瀚,等.成人急性阑尾炎病变阑尾解剖位置的多层螺旋CT评价[J].四川医学,2016,37(07):823-826.
3刘新爱,王同明,任月勤.三种病理类型急性阑尾炎患者的临床体征及多层螺旋CT征象特点差异性分析[J].中国CT和MRI杂志,2017,15(08):124-127.
4杨虎,王健,吴晋,等.腹部CT的影像诊断在阑尾炎患者术前应用中的探讨[J].新疆医学,2016,46(09):1144-1147.
5唐剑辉,李光明,曾军.改良Alvarado评分系统结合多层螺旋CT在诊断急性阑尾炎方面的临床价值研究[J].中华临床医师杂志(电子版),2016,10(10):1427-1431.
6李光明,李智锋,孙小会,等.多层螺旋CT征象诊断急性阑尾炎病理类型的价值[J].中国医学影像学杂志,2016,24(06):451-454.
7杨家辉,毛巨江,崔冬冰,等.多层螺旋CT对急性阑尾炎及其并发症的诊断价值[J].贵州医科大学学报,2017,42(11):1349-1352.
8杨峰,周静然,赵传军.基于腹部横截面积的低剂量CT扫描诊断急性阑尾炎的可行性[J].中国介入影像与治疗学,2016,13(05):302-305.