摘要
目的探讨螺旋CT与高频彩超应用于非典型急性阑尾炎诊断中的临床价值。方法分析60例临床拟诊为急性阑尾炎,但症状不典型患者的病历资料,术前均行螺旋CT与高频彩超检查,以手术-病检结果为金标准,将螺旋CT与高频彩超检查的结果进行比较分析。结果术后诊断正常阑尾20例,急性阑尾炎40例(其中水肿性15例,蜂窝织炎性15例,坏疽性10例)。CT诊断非典型急性阑尾炎的敏感性、特异性、准确性分别为92.5%、85.0%和90.0%,均明显高于高频彩超的74.3%、44.0%和61.7%(P<0.05);CT诊断水肿性及蜂窝织炎性阑尾炎的敏感性分别为86.7%、93.3%,明显高于高频彩超的40.7%、66.7%(P<0.05);而两种检查方法对坏疽性阑尾炎诊断的敏感性无显著性差异(P>0.05)。结论螺旋CT较高频彩超在非典型急性阑尾炎的诊断中更具优势。对于症状不典型,但临床疑诊急性阑尾炎的患者,可行螺旋CT检查以明确诊断。
Objective To explore the clinical value of spiral CT in the diagnosis of atypical acute appendicitis. Methods A retrospective analysis of the medical records of 60 patients with clinical diagnosis of acute appendicitis intended, but clinical symptoms were not typical. Before surgery, patients were given spiral CT and highfrequency ultrasound examination to surgery-pathology results as the gold standard, the results of the spiral CT and high-frequency ultrasonography were compared and analyzed. Results Postoperative diagnosis： 20 cases of normal appendix, 40 cases of acute appendicitis （including： 15 cases of edema, 15 cases of cellulitis, gangrenous 10 cases）. CT diagnosis of atypical acute appendicitis sensitivity, specificity, accuracy （respectively： 92.5%, 85.0%, 90.0%） was significantly higher than that of high-frequency ultrasound （respectively： 74.3%, 44.0%, 61.7%） （P〈0.05）; CT diagnosis of appendicitis edema and cellulitis sensitivity （respectively： 86.7 %, 93.3 %） was significantly higher than that of high-frequency ultrasound （respectively： 40.7%, 66.7%） （P〈0.05） ; while the two methods comparison of the sensitivity of the diagnosis of gangrenous appendicitis, the difference was significant （P〉0.05）. Conclusion Spiral CT have an advantage in the diagnosis of atypical acute appendicitis compared with high-frequency ultrasound. If clinical symptoms are not typical, but clinically suspected acute appendicitis, such as high-frequency ultrasound test results were negative, spiral CT should be further examined to confirm the diagnosis.
出处
《西部医学》
2015年第4期595-597,共3页
Medical Journal of West China
