哈尔滨市双城区中医医院 黑龙江 哈尔滨 150100
摘要：目的：探究肠梗阻的腹部X线平片和CT诊断的临床应用价值。方法：选取我院收治的50例肠梗阻患者。通过与手术病理的对照，分析腹部CT和X线平片检查在判断有无肠梗阻及其类型、部位及病因的准确性。结果：在50例肠梗阻病例中，判断肠梗阻是否存在：CT检查诊断49例（98%），X线平片诊断41例（91.1%）（P＜0.05）诊断肠梗阻部位：CT正确诊断45例（90%），X线平片正确诊断34例（68%）（P＜0.05）。判断肠梗阻类型：其中单纯机械性肠梗阻有36例，CT正确诊断33例（91.6%），X线平片正确诊断32例（88.8%）（P＞0.05）；绞窄性肠梗阻有8例：CT正确诊断7例（87.5%），X线平片正确诊断诊断（12.5%）（P＜0.05）；动力性肠梗阻有6例，CT正确诊断5例（83.3%），X线平片正确诊断4例（66.7%）（P＞0.05）。判断肠阻的病因：CT正确诊断45例（90%），X线平片正确诊断26例（52%）（P＜0.05）。结论：在肠梗阻的临床诊断中，CT诊断方法较腹部X线平片具有优势显著的诊断效果，值得临床广泛应用。
关键词：肠梗阻；腹部X线平片，CT；诊断效果
Abdominal X-ray plain film and CT diagnosis of intestinal obstruction
Abstract : Objective: To explore the clinical value of abdominal X-ray and CT diagnosis of intestinal obstruction. Methods: We selected 50 patients with intestinal obstruction admitted to our hospital. By comparing with the surgical pathology, abdominal CT and X-ray examination were used to determine the accuracy of intestinal obstruction and its type, location, and etiology. Results: In 50 cases of intestinal obstruction, the presence of intestinal obstruction was diagnosed: CT diagnosis of 49 cases (98%), X-ray plain film diagnosis of 41 cases (91.1%) (P <0.05) diagnosis of intestinal obstruction site: CT correct diagnosis Forty-five patients (90%) were correctly diagnosed with X-ray plain film in 34 cases (68%) (P<0.05). Types of intestinal obstruction were judged: 36 cases with simple mechanical ileus, 33 cases (91.6%) diagnosed correctly by CT, 32 cases (88.8%) correctly diagnosed by X-ray plain film (P>0.05), and 8 cases of strangulated intestinal obstruction. Cases: 7 cases (87.5%) were correctly diagnosed by CT, 12 cases were diagnosed correctly by X-ray plain film (12.5%) (P<0.05), 6 cases had dynamic intestinal obstruction, 5 cases were correctly diagnosed by CT (83.3%), X-ray The correct diagnosis of 4 cases (66.7%) (P> 0.05). The cause of intestinal obstruction was judged: CT was correctly diagnosed in 45 cases (90%), and X-ray plain film was correctly diagnosed in 26 cases (52%) (P<0.05). Conclusion: In the clinical diagnosis of intestinal obstruction, the CT diagnosis method is superior to the abdominal X-ray film in the diagnosis of a significant advantage, it is worthy of extensive clinical application.
Key words: intestinal obstruction; abdominal X-ray, CT; diagnostic effect
在临床中，肠梗阻是比较常见的急腹症，主要是由于肠腔发生机械性或者是物理性的阻塞所引发的，通常情况下结肠与小肠都有发生肠梗阻的可能性。随着影像学技术的飞速进步与发展，螺旋CT在肠梗阻的诊断中取得了较好的应用效果，在诊断肠梗阻疾病上应用效果显著。本文主要分析肠梗阻患者经CT、腹部X线平片诊断的效果，现作如下报道。
1资料和方法
1.1基本资料
选取我院2016年9月-2017年9月收治的50例肠梗阻患者。男32例，女18例，平均（43.5±11.5）岁。经病理证实诊断均为肠梗阻患者，在临床上均有不同程度的呕吐、腹胀、腹痛、排便障碍和排气困难等症状。所有患者均充分了解本研究，并签署知情同意书。
1.2基本方法
腹部X线平片检查采用东芝产KXO-15R型DR数字X线摄片机，站立位下行腹部摄片。CT检查采用飞利浦MX16型16层螺旋CT机，层距为5-8mm，层厚为5-8mm，在扫描以后一些患者需要拆薄图像2.5mm，并且采取平面重建。怀疑为绞窄性肠梗阻患者需要延2-3min以后再进行扫描，并且对CT诊断的结果作进一步的分析。
2结果
表1 50例肠梗阻平片、CT与手术病例诊断结果比较［n，（%）］
3讨论
综上所述，与平片相比，CT技术的应用具有更高的诊断价值，能够显示患者的肠梗阻部位，获取较高的分辨率，将腔内积液、肠管内径等信息显示出来，明确梗阻部位的肠管形态，便于观察梗阻移行区域内的粪石、胆石、肿瘤等情况，诊断患者病情。值得在临床上进行推广。
参考文献
[1]邓一军.腹部X线平片和CT检查在肠梗阻诊断中的价值[J].医学影像,2016,4（22）:49-50.
[2]薛劲生.肠梗阻的腹部X线平片和CT诊断[J].临床医药文献杂志,2017,4（68）:13402-13403.
[3]戴勇山.肠梗阻的腹部X线平片和CT诊断探析[J].中外医学研究,2017,15（1）:59-60.
论文作者:李兆华
论文发表刊物:《中国研究型医院》2018年5卷2期
论文发表时间:2018/7/3
标签：肠梗阻论文; 腹部论文; 正确论文; 患者论文; 部位论文; 肠管论文; 效果论文; 《中国研究型医院》2018年5卷2期论文;