摘要
目的比较全面腹部超声与选择性腹部超声检查在胃肠道穿孔临床诊断中的应用价值。方法选择2024年1月至2025年1月于我院就诊的68例疑似胃肠道穿孔患者,均实施选择性腹部超声、全面腹部超声检查,以手术结果为金标准,比较两种检查方式的诊断效能。结果以手术结果为金标准,全面腹部超声检查发现真阳性43例、真阴性22例,选择性腹部超声检查发现真阳性36例、真阴性15例。全面腹部超声检查灵敏度97.73%、特异度91.67%、准确率95.59%、阳性预测值95.56%、阴性预测值95.65%,均高于选择性腹部超声检查的81.82%、62.50%、75.00%、80.00%、65.22%(P<0.05);全面腹部超声检查与金标准的一致性为0.854,高于选择性腹部超声检查的0.821。全面腹部超声对十二指肠前壁的检出率为100.00%,明显高于选择性腹部超声的81.82%(P<0.05)。相较于选择性腹部超声检查,全面腹部超声检查的诊断时间较短,但检查时间较长(P<0.05)。结论在胃肠道穿孔的临床诊断中,全面腹部超声与选择性腹部超声检查均能提供可靠的影像学依据,特别是在紧急评估急腹症病例时,这两种检查策略通过无创、可重复影像学手段,能有效识别腹腔游离气体、异常积液等关键病理征象,为疾病鉴别及治疗方案制定提供重要参考依据,但全面腹部超声检查灵敏度、准确率更高,可为临床明确具体穿孔位置,为临床诊疗提供参考。
Objective To compare the application value of comprehensive abdominal ultrasound and selective abdominal ultrasound examination in the clinical diagnosis of gastrointestinal perforation.Methods A total of 68 patients with suspected gastrointestinal perforation admitted to our hospital from January 2024 to January 2025 were selected.All of them underwent selective abdominal ultrasound and comprehensive abdominal ultrasound examination.Taking the surgical results as the gold standard,the diagnostic efficacy of two examination methods was compared.Results Taking the surgical results as the gold standard,comprehensive abdominal ultrasound examination revealed 43 true positive cases and 22 true negative cases,while selective abdominal ultrasound examination revealed 36 true positive cases and 15 true negative cases.The sensitivity,specificity,accuracy,positive predictive value,and negative predictive value of comprehensive abdominal ultrasound was 97.73%,91.67%,95.59%,95.56%,and 95.65%,respectively,higher than 81.82%,62.50%,75.00%,80.00%and 65.22%of selective abdominal ultrasound(P<0.05);the comprehensive abdominal ultrasound showed an agreement of 0.854 with the gold standard,which was higher than the 0.821 agreement of the selective abdominal ultrasound.The detection rate of anterior wall of the duodenum by comprehensive abdominal ultrasound was 100.00%,significantly higher than 81.82%by selective abdominal ultrasound(P<0.05).Compared with the selective abdominal ultrasound,the diagnostic time of comprehensive abdominal ultrasound was shorter,while the examination time was longer(P<0.05).Conclusions In the clinical diagnosis of gastrointestinal perforation,both comprehensive abdominal ultrasound and selective abdominal ultrasound examination can provide reliable imaging evidence,particularly in the emergent evaluation of acute abdominal cases.These non-invasive and reproducible imaging strategies can effectively detect key pathological signs such as free intraperitoneal gas and abnormal fluid accumulation,thereby offering critical references for differential diagnosis and treatment planning.However,comprehensive abdominal ultrasound demonstrates higher sensitivity and accuracy,which aids in clarifying the precise location of perforation and provides valuable guidance for clinical decision-making.
作者
石瑶
张剑
李淑明
李志海
SHI Yao;ZHANG Jian;LI Shuming;LI Zhihai(Dalang Hospital,Dongguan 523770,China)
出处
《临床医学工程》
2026年第2期221-224,共4页
Clinical Medicine & Engineering
关键词
全面腹部超声
选择性腹部超声
胃肠道穿孔
临床诊断
诊断时间
Comprehensive abdominal ultrasound
Selective abdominal ultrasound
Gastrointestinal perforation
Clinical diagnosis
Diagnostic time
