摘要
目的探究急性阑尾炎不同病理类型患者临床体征表现及MSCT的诊断价值。方法回顾性选取2015年1月至2018年1月我院普外科收治的102例急性阑尾炎患者作为研究对象,按其病理类型分为三组,A组(n=46)为急性单纯性阑尾炎患者,B组(n=42)为急性化脓性阑尾炎患者,C组(n=14)为急性坏疽性阑尾炎患者;观察并比较各组患者临床体征[阑尾炎患者典型阵发疼痛、无典型症状伴有轻压痛、体温>39℃、腹肌紧张],MSCT检查征象[阑尾炎患者脂肪厚度、阑尾直径、阑尾粪石嵌顿、阑尾周围积液、游离复盘腔积液]以及MSCT检查结果与病理结果。结果在临床体征上,三组患者典型阵发疼痛、无典型症状伴有轻压痛、体温>39℃的例数比较,差异无统计学差异(t=0.734、0.402、4.219,P>0.05);腹肌紧张例数比较差异显著(t=12.042,P<0.05)。MSCT检查征象中,三组患者脂肪厚度、阑尾直径及阑尾周围积液例数比较差异显著(t=49.120、97.058,χ2=8.683;P<0.05),阑尾粪石嵌顿、游离复盘腔积液例数比较差异无统计学意义(χ2=0.837,P>0.05)。在MSCT检查结果与病理结果比较上,三组差异无统计学意义(χ2=0.837,P>0.05),其中A、B、C三组MSCT检查的准确率分别为93.48%、95.24%、92.86%。结论急性阑尾炎不同病理类型患者大多临床体征表现不典型,脂肪厚度、阑尾直径及阑尾周围积液等可作为MSCT检查的主要象征,其检查准确率较高,因此在急性阑尾炎病理分型诊断中指导价值较高,值得临床推广使用。
Objective To explore the clinical signs and the diagnostic value of MSCT in patients with different pathological types of acute appendicitis.Methods A retrospective study of 102 patients with acute appendicitis admitted to our hospital from January 2015 to January 2018 was divided into three groups according to their pathological type.Group A(n=46)was an acute simple appendicitis patient.Group B(n=42)was acute suppurative appendicitis patients,group C(n=14)was acute gangrenous appendicitis patients;clinical signs[Appendicitis patients with typical paroxysmal pain,no typical symptoms with mild tenderness,body temperature>39℃,abdominal muscle tension],MSCT examination signs[Fat thickness of the appendicitis patient,diameter of the appendix,incarceration of the appendix,appendix around the appendix,free pleural effusion],MSCT examination results and pathological results were observed and compared.Results In the clinical signs,the typical group of patients with paroxysmal pain,no typical symptoms with mild tenderness,body temperature>39℃cases were not significantly different(t=0.734、0.402、4.219,P>0.05);abdominal muscle tension.The difference was significant(t=12.042,P<0.05).Among the MSCT examination signs,the fat thickness,the diameter of the appendix and the number of effusions around the appendix in the three groups were significantly different(t=49.120、97.058,χ2=8.683;P<0.05),incarceration of the appendix,free complex cavity product There was no significant difference in the number of liquids(χ2=0.837,P>0.05).In the comparison of MSCT test results and pathological results,the differences between the three groups were not significant(χ2=0.837,P>0.05).The accuracy rates of MSCT in groups A,B and C were 93.48%and 95.24%,respectively 92.86%.Conclusion Most of the patients with different pathological types of acute appendicitis have atypical clinical signs.Fat thickness,appendix diameter and periappendiceal effusion can be used as the main symbols of MSCT examination.The accuracy of MSCT examination is high.Therefore,it has a high guiding value in the pathological classification of acute appendicitis and is worthy of clinical application.
作者
周桂荣
ZHOU Gui-rong(Department of CT Room,Chaohu Hospital,Anhui Medical University,Chaohu 238000,Anhui Province,China)
出处
《中国CT和MRI杂志》
2020年第12期128-131,共4页
Chinese Journal of CT and MRI
