摘要
目的探析数字摄影(DR)技术在疑似肠梗阻患者筛查中的应用和诊断价值。方法选取2016年2月至2017年12月75例疑似肠梗阻患者进行回顾性研究,所选患者均于入院48 h内行DR、CT检查。以手术结果为金标准,计算DR及CT的检查诊断效能,比较DR及CT的检查符合率、肠管扩张检查准确率、肠管积液检查准确率。结果 75例患者中,经手术证实肠梗阻患者63例。梗阻部位:小肠37例(58. 73%),结肠26例(41. 27%)。梗阻性质:机械性36例(57. 14%),绞窄性25例(39. 68%),麻痹性2例(3. 18%)。梗阻程度:完全性肠梗阻24例(38. 10%),不完全性肠梗阻39例(61. 90%)。以手术检查结果为金标准,DR检查灵敏度为87. 30%,特异度为83. 33%,误诊率为16. 67%,漏诊率为12. 70%,符合率为86. 67%,阳性预测值为96. 49%,阴性预测值为55. 56%;MSCT检查灵敏度为92. 06%,特异度为91. 67%,误诊率为8. 33%,漏诊率为7. 94%,符合率为92. 00%,阳性预测值为98. 31%,阴性预测值为68. 75%。DR与MSCT检查符合率、肠管扩张与肠管积液的检查准确率比较差异均无统计学意义(P> 0. 05)。结论 DR与CT检查肠梗阻均具有良好效果,对肠管扩张及积液情况的检查效果相当,可为治疗方案提供参考。而DR射线量小、简便易行、价格低廉,且可筛查胃和肠黏膜皱襞小病灶,更适合作为肠梗阻的初步筛查手段。
Objective To investigate the application and diagnostic value of digital radiography（DR） technique in the screening of patients with suspected intestinal obstruction. Methods Seventy-five patients with suspected intestinal obstruction were selected for retrospectively study and underwent DR and CT examinations within 48 hours after admission.The diagnostic accuracy of DR and CT was calculated according to the gold standard of operation results,and the coincidence rate and the accuracy rate for intestinal dilatation and intestinal fluid collection were compared between DR examination and CT examination. Results Out of 63 cases of intestinal obstruction confirmed by surgery,37 cases located in small intestine（58. 73%）,and 26 cases located in colon（41. 27%）; there were 36 cases of mechanical obstruction（57. 14%）,25 cases of strangulated obstruction（39. 68%）,2 cases of paralytic obstruction（3. 18%）. There were 24 cases of complete intestinal obstruction（38. 10%） and 39 cases of incomplete intestinal obstruction（61. 90%）. Based on the gold standard of surgical results,the sensitivity,specificity,misdiagnosis rate,missed diagnosis rate,coincidence rate,positive predictive value and negative predictive value were 87. 30%,83. 33%,16. 67%,12. 70%,86. 67%,96. 49% and55. 56% respectivelyby DR and 92. 06%,91. 67%,8. 33%,7. 94%,92. 00%,98. 31% and 68. 75% respectively by MSCT. There were no significant differences in the coincidence rate between DR and MSCT,the accuracy rate of intestinal dilatation and intestinal effusion between DR and MSCT（P〈0. 05）. Conclusions Both DR and CT have good effect in checking intestinal obstruction and have similar check effect on bowel dilatation and effusion,which can be used as a reference for treatment. However,DR examination is easy to operate,small amount of radiation,inexpensive and can screen the small lesions of gastric and intestinal mucosa folds,so as to be more suitable as a primary screening method for intestinal obstruction.
作者
黄群国
代小兵
周莹
雷作强
何禹红
赵丹
HUANG Qun-guo;DAI Xiao-bing;ZHOU Ying;LEI Zuo-qiang;HE Yu-hong;ZHAO Dan(Department of Radiology,Mianyang Central Hospital,Mianyang,Sichuan 621000,China)
出处
《中国临床研究》
CAS
2018年第11期1571-1573,1577,共4页
Chinese Journal of Clinical Research
关键词
肠梗阻
数字摄影技术
多层螺旋CT
筛查
诊断
Intestinal obstruction
Digital radiography
Muhislice computed tomography
Screening
Diagnosis
