超声诊断急性阑尾炎50例分析

目的：分析超声诊断急性阑尾炎的误诊原因，旨在进一步提高急性阑尾炎的诊断水平。方法：总结分析我院2004—06以来，50例经临床诊断．手术及病理证实的急性阑尾炎的超声检查结果，重点讨论各型阑尾炎的超声表现及误诊原因。结果：50例超声检查急性阑尾炎的患者，均经手术及病理证实。急性单纯性阑尾炎5例，B超诊断符合4例，误诊为化脓性阑尾炎1例；急性化脓性阑尾炎27例，B超诊断符合27例；坏疽性阑尾炎11例，伴穿孔2例，B超诊断符合7例，误诊为化脓性阑尾炎4例；阑尾周围脓肿7例，B超诊断符合5例，误诊2例，其中1例误诊为右侧卵巢巧克力囊肿，1例误诊为结肠肿瘤。结论：超声检查在临床诊断急性阑尾炎及其他急腹症的鉴别诊断中具有重要作用，并可为阑尾炎的分型提供参考依据。     

超声在急性阑尾炎诊断中的应用

目的 评估超声在急性阑尾炎诊断中的价值和意义。方法 回顾性分析98例手术病理证实的住院患者的临床和超声资料。结果 超声诊断为急性阑尾炎者89例，诊断符合率为89．8％，误诊1例，漏诊9例，误漏诊率10．2％。结论 超声可作为诊断和鉴别诊断急性阑尾炎的首选影像学诊断方法。     

超声诊断急性阑尾炎的临床价值探讨

目的探讨超声在急性阑尾炎诊断中的价值。方法回顾性分析经手术、病理证实的急性阑尾炎患者240例临床资料。其中临床加超声诊断组140例；单纯临床诊断组100例。结果临床加超声诊断组正确129例，诊断符合率92．1％，漏误诊11例，漏误诊率7．9％；单纯临床诊断组正确76例，诊断符合率76．0％，漏误诊24例，漏误诊率24．0％。结论急性阑尾炎使用临床加超声诊断，可明显提高诊断符合率。     

变频超声分型诊断阑尾炎的价值

目的探讨变频超声分型诊断阑尾炎的价值。方法应用超声的变频凸阵探头（2．6～6．5MHz）检查结合临床资料分型诊断阑尾炎218例，并将检查结果与手术及病理对照。结果保守治疗62例达到临床治愈；156例经手术及病理证实，超声诊断符合率95．5％（149／156）。超声分型诊断符合率：单纯型急性阑尾炎88．6％（31／35），化脓型急性阑尾炎94．8％（55／58），坏疽型急性阑尾炎86．5％（45／52），慢性阑尾炎发作型90．9％（10／11）。结论变频超声可动态观察阑尾炎的声像图变化，分型诊断阑尾炎能及时为临床正确选择治疗方案提供参考依据。     

急性阑尾炎的超声诊断及分型探讨

目的 分析急性阑尾炎的超声表现及病变程度，探讨急性阑尾炎超声分型的临床价值。方法 回顾分析122例经手术及病理证实急性阑尾炎的超声图像资料，对其声像图特征进行分型。结果 本组122例中，急性单纯性阑尾炎21例，超声诊断符合率76．2％（16／21）；急性化脓性阑尾炎66例，超声诊断符合率90．9％（60／66）；急性坏疽性阑尾炎18例，超声诊断符合率83．3％（15／18）；阑尾周围脓肿17例，超声诊断符合率100％。结论 超声对急性阑尾炎的诊断及分型具有重要的临床价值。     

急性阑尾炎的超声诊断价值

目的：熟练掌握急性阑尾炎的超声图像特征及超声诊断急性阑尾炎的影像价值。方法应用百胜MYLABSIX＋彩超,探头频率7．5～10 Hz对69例经超声诊断的急性阑尾炎患者影像诊断进行回顾性分析总结。结果69例阑尾炎中,急性阑尾炎、化脓性阑尾炎63例,诊断符合率76％,其中阑尾内有粪石或粪石嵌塞的3例,诊断符合率91％,阑尾周围脓肿3例,超声诊断符合率为95％,上述病例均行超声检查及手术病理证实。结论超声诊断急性阑尾炎为患者提供了一个直接、简便、安全的方法,为临床提供客观的诊断依据。     

急性阑尾炎的超声表现与病理对照分析

目的探讨超声在急性阑尾炎诊断中的应用价值。方法通过对临床诊断为急性阑尾炎行超声检查的218例患者的回顾性分析，比较超声检查、手术及病理结果。结果218例中167例超声诊断为阑尾炎。均为手术、病理所证实；20例为其他急腹症；33例超声检查阴性，其中11例为阑尾炎，8例为单纯性阑尾炎，3例为后位阑尾炎，超声诊断急性阑尾炎的敏感性为94．5％，特异性为100％。结论超声检查是急性阑尾炎简便有效的辅助诊断方法，对可疑病例进行常规检查可明显降低误诊误治率。     

便携式彩色多普勒超声在急性阑尾炎诊断中的价值

目的探讨便携式彩色多普勒超声在诊断急性阑尾炎中的临床应用与诊断价值。方法将227例下腹痛临床疑诊阑尾炎的患者分为两组，对照组接受普通超声检查，干预组接受便携式彩色多普勒超声检查，分别将两组超声诊断结果与手术病理结果比较后，对比分析两组相关数据。结果干预组超声诊断急性阑尾炎且进入手术88例，经病理证实84例，阳性符合率95．45％（84／88），误诊4例，误诊率4．55％（4／88），漏诊2例，漏诊率2．33％（2／86）；对照组超声诊断急性阑尾炎且进入手术86例，经病理证实80例，阳性符合率93．02％（80／86），误诊6例，误诊率6．98％（6／86），漏诊5例，漏诊率5．88％（5／85）。干预组平均候检时间1．5h，平均住院时间124h；对照组平均候检时间5．9h，平均住院时间147h。结论便携式彩超检查体积小巧，方便快捷，性能更佳，可以随时反复进行，及时发现早期病变，及时接受手术治疗，缩短住院时间和减少不良并发症，对于帮助临床医师提高早期诊断率，减少不良并发症有重要价值。     

超声诊断阑尾炎与手术病理结果对比分析

目的探讨阑尾炎超声诊断的价值。方法术前超声诊断急性阑尾炎患者共186例。与手术、病理结果进行对比分析。结果超声诊断与手术及病检结果对照：阑尾长度与手术相差约1．5～3．2cm，内径相差约0．2cm，诊断符合率95．6％。结论应用腹部超声诊断阑尾炎具有重要的临床价值。     

急性阑尾炎的超声诊断价值

目的 探讨超声对急性阑尾炎的诊断价值。方法 对148例急性阑尾炎患者进行超声检查。结果 病变阑尾回声及周围的回声特征与病理类型相关。其中急性单纯性阑尾炎48例（32．4％），急性化脓性阑尾炎56例（37．9％），坏疽穿孔性阑尾炎24例（16．2％），阑尾周围脓肿20例（13．5％）。结论 超声是诊断急性阑尾炎的有效方法。     

超声对粪石性阑尾炎的诊断价值及其临床意义

目的探讨超声对粪石性阑尾炎的诊断价值及其临床意义。方法对经手术病理证实的45例粪石性阑尾炎进行回顾性超声分析。结果本组45例粪石性阑尾炎的超声诊断符合率97．7％（44／45）,超声所提示的粪石大小、数目与手术病理一致。45例粪石性阑尾炎中,单纯性阑尾炎5例,化脓性阑尾炎28例,坏疽性阑尾炎9例,慢性阑尾炎急性发作3例。其中一例粪石性阑尾炎同时合并回盲部肿瘤。结论超声可以作为粪石性阑尾炎的术前诊断依据,能明确阑尾炎是否伴粪石形成,以及粪石的大小,数目,具有很高的超声诊断价值及临床应用价值。     

以急性阑尾炎为表现的结肠癌的诊断与治疗

目的：分析表现为急性阑尾炎的结肠癌漏诊的原因，探讨及时诊断、治疗的措施。方法：对我院近10年收治的表现为急性阑尾炎的结肠癌27例I临床资料作回顾分析。结果：27例首次诊断急性阑尾炎(外院5例)，全部作阑尾切除，术中诊断结肠癌15例，12例作Ⅰ期结肠癌根治术，3例无法根治；漏诊12例(外院5例)，术后3天—6个月诊断结肠癌，8例作Ⅱ期结肠癌根治术，3例无法根治，1例放弃治疗。病理诊断：结肠癌26例，急性阑尾炎17例，慢性阑尾炎5例。26例治愈出院，1例放弃诊疗。随访9例，生存3年以上5例，生存5年以上4例。结论：对本病认识不足是漏诊的主要原因，提高认识、重视腹腔探查可提高诊断率，确诊后应及时Ⅰ期手术根治。     

Integrated clinical-ultrasonographic diagnosis in acute appendicitis

PurposeAcute appendicitis is one of the commonest diseases encountered in the field of emergency surgery. If untreated, it can rapidly develop severe complications such as perforation and peritonitis. Surgeons therefore often choose early surgical treatment also when the diagnosis is only probable, facing the risk of performing an elevated amount of unnecessary appendectomies. The aim of this study is to analyse our experience with integrated clinical-ultrasonographic diagnosis in acute appendicitis.Material and methodsFrom January 1999 to December 2006, 1447 patients underwent clinical examination, leucocyte count, evaluation of C-reactive protein level, and abdominal ultrasonography using graded compression technique and a high frequency probe.ResultsIn 368 patients (25%) ultrasonographic diagnosis was acute appendicitis; 8 patients were operated on the basis of clinical evaluation only. Ultrasonography yielded false positive results in 7 cases. In 1079 patients (75%) diagnosis was negative for acute appendicitis; 173 of these patients (12%) received a different diagnosis. The remaining 906 patients underwent clinical follow-up until the symptoms disappeared; there were no complications. In our study, sensitivity of ultrasonography was 98%, specificity 99%, positive predictive value 98%, and negative predictive value 99%. Overall diagnostic accuracy was 99%.ConclusionIntegrated diagnosis of acute appendicitis based on clinical evaluation, laboratory tests and ultrasonography is safe and saves resources by preventing unnecessary operations.     

超声对临床不典型阑尾炎的诊断价值

目的 探讨高低频超声结合诊断症状不典型阑尾炎的临床应用价值.方法 对102例经手术病理证实且临床症状体征不典型的阑尾炎进行声像图回顾性分析.结果 102例患者超声提示阑尾炎71例,阑尾黏液囊肿2例,阑尾穿孔4例,超声仅提示腹腔和(或)盆腔积液的5例,右下腹肠系膜淋巴结肿大4例,右下腹局部肠管扩张6例(伴肠间隙少量积液3...     

超声对急性阑尾炎的诊断价值

目的 探讨阑尾炎的声像图特征及超声对阑尾炎的诊断价值.方法 应用低频结合高频超声对142例急性阑尾炎患者进行检查,并将观察结果 与手术结果 对照.结果 阑尾炎的超声诊断符合率为83.10%.142例中急性单纯性阑尾炎53例,占37.32% ;急性化脓性阑尾炎71例,占50%;坏疽性阑尾炎13例,占9.15%;阑尾周围脓肿5例,占3 .52%.结论 超声检查尤其是高频超声对急性阑尾炎的诊断具有重要价值 .     

Acute diverticulitis in patients 40 years of age and younger

Acute colonic diverticulitis typically occurs in patients older than 60 years of age but is uncommon in patients under the age of 40, which may lead to a delay in diagnosis. Because abdominal pain is a very common presenting symptom in emergency department patients, we retrospectively analyzed the cases of 21 patients 40 years of age and younger diagnosed with acute diverticulitis and characterized the presenting signs and symptoms, laboratory and radiographic findings, treatment, and outcome. There were 17 men and 4 women with a mean age of 34.1 +/-5.9 years. All patients had abdominal pain, with 14 (67%) patients noting pain in the left lower quadrant (LLQ) and 5 (24%) patients noting right lower quadrant (RLQ) pain. Nausea was present in 18 (86%) patients and fever in 15 (71%) patients. The mean pulse rate was 103 +/- 16 and the mean temperature was 100.7 +/- 1.4 F. Leukocytosis was present in 19 (90%) patients. Plain abdominal radiographs were obtained in 19 (91%) patients and were normal in 15 (79%) of these cases. Computed tomographic (CT) scans were obtained in 15 (71%) patients which revealed findings consistent with acute diverticulitis in 14 (93%) patients. The admitting diagnosis was diverticulitis in 10 of the 12 patients with LLQ tenderness and appendicitis in 4 of the 6 patients with RLQ tenderness. Overall, six patients were taken to surgery: three patients had cecal diverticulitis and three patients had perforated colonic diverticulitis. General treatment measures included bowel rest in 18 (86%) patients, and intravenous fluids and antibiotics in all patients. All patients survived. In conclusion, acute diverticulitis is uncommon in patients under 40 years of age; however, this condition may be confused with other conditions, usually acute appendicitis. As a result, clinicians should consider acute diverticulitis in young patients with acute abdominal pain, especially if they are male with nausea, fever, tachycardia, and leukocytosis, and consider obtaining a CT scan to aid in the diagnosis.     

Saline-filled appendiceal ultrasonography in clinically equivocalacute appendicitis

Background: To establish the value of saline-filled appendiceal ultrasonography in the the diagnosis of clinically equivocal acute appendicitis. Methods: Saline-filled ultrasonography was performed in 43 patients with an equivocal clinical diagnosis of acute appendicitis. Results: Sonography diagnosed 31 of 32 patients without acute appendicitis (97%). A normal appendix was visualized in 15 patients (47%), and we identified a normal appendix in 15 of 22 patients (68%) in whom the colon was cleansed with Golytely?. Sonography diagnosed 10 of 11 patients with acute appendicitis (91%). In three of 10 patients, the findings corresponded to sonographic pitfalls. Conclusion: Saline-filled appendiceal ultrasonography enables the detection of a normal appendix and may overcome sonographic pitfalls in acute appendicitis. Received: 2 June 1995/Accepted: 18 July 1995     

高低频探头联合使用在急性阑尾炎中的诊断价值

目的探讨联合使用高低频探头在急性阑尾炎中的诊断价值。方法回顾性分析了122例急性阑尾炎的临床资料,对比超声诊断与手术病理结果。结果 122例中,超声诊断阑尾炎110例,漏诊8例,误诊4例,诊断符合率90.16%(110/122);术前超声诊断分型与术后病理分型对比,122例中作了分型的110例中有95例与病理分型一致,诊断符合率为86.4%(95/110)。结论高低频探头联合应用提高了阑尾炎诊断符合率,且在阑尾炎病理分型中有重要应用价值。     

超声在急性阑尾炎临床诊断和分型中的临床意义

目的 探讨超声在急性阑尾炎诊断及病理分型中的作用和意义.方法 回顾2010年4月～2011 年11月急诊就诊的急腹症患者168例,均进行手术治疗,比较术前超声检查诊断结果 与术后病理检查结果 的差异.结果 单纯性阑尾炎超声诊断准确率为97.1%,化脓性阑尾炎准确率为95.2%,坏疽性阑尾炎准确率为100%,超声总的诊断准确率为97.1%;阑尾炎组的阑尾超声结果 显示其阑尾直径、长度、管壁厚度均高于非阑尾炎急腹症患者(P＜0.01).结论 超声检查对急性阑尾炎诊断准确率很高,具有重要的诊断价值,应作为首选辅助诊断方法.