彩色多普勒超声诊断上消化道穿孔的价值分析

目的探讨彩色多普勒超声对上消化道穿孔诊断的应用价值。方法对72例急症上腹痛患者行彩色多普勒超声检查,通过分析超声影像有无腹腔游离气体及腹腔间隙游离液区,初步诊断上消化道穿孔。结果72例患者,应用彩色多普勒超声检查,有31例观察到隔下、剑突下、右上腹部出现游离气体声像,经临床手术证实上消化道穿孔28例,诊断符合率为90%,2例急性胰腺炎,1例高位肠梗阻;41例观察到右上腹小网膜囊间隙、右侧髂窝间隙或左侧腹小肠间隙游离液区,经临床诊断有14例为上消化道穿孔,诊断符合率为34%,其余27例中分别为4例肠梗阻,4例回盲部肠炎,19例急性阑尾炎。同时观察到腹腔游离气体和腹腔积液17例,临床诊断为上消化道穿孔14例,诊断符合率为82%,其余3例为急性胰腺炎。讨论彩色多普勒超声作为简便、无创、对气体及液体敏感性较强等优点,能够及时对急性上消化道穿孔做出较为准确的诊断,从而为临床诊断提供重要的临床价值,争取在短时间内治愈疾病,减轻患者痛苦,值得临床推广。

Color doppler ultrasound diagnostic value of upper gastrointestinal tract perforation

Objective To investigate the color doppler ultrasonography in diagnosing upper gastrointestinal perforation application and it′s clinical significance.Methods Seventy-two cases with acute abdominal pain underwent color doppler examination,who were diagnosed preliminarily as upper gastrointestinal tract perforation on the basis of the analysis of ultrasonic image under the presence of free gas in abdominal cavity and peritoneal clearance free liquid area.Results Of 72 patients with the application of color doppler ultrasound,free gas audio-visual were observed under the diaphragm,or under xiphoid process of upper right abdomen in 31 cases,28 cases with upper gastrointestinal perforation were confirmed by clinical surgery,and the diagnostic coincidence rate was 90%,there are 2 cases with acute pancreatitis and 1 case with high intestinal obstruction;free fluid clearance area were observed in right upper quadrant lesser omentum sac clearance,clearance of the right iliac fossa,or on the left side of the abdomen small intestine in 41 cases,14 cases with upper gastrointestinal perforation were clinically diagnozed,and the diagnostic coincidence rate was 34%,for the other 27 cases,there are 4 cases with intestinal obstruction,4 cases with ileocecitis,and 19 cases with acute appendicitis.Free gas and peritoneal effusion were also observed in the abdominal cavity of 17 cases,14 cases with upper gastrointestinal perforation were clinical diagnosed with the diagnostic coincidence rate of 82%,the remaining 3 cases were acute pancreatitis.Conclusion For patients with acute upper gastrointestinal perforation of acute abdominal pain,The disease progresses rapidly,and are prone to septic shock and life-threatening.Color doppler ultrasound is simple,noninvasive and sensitive to gas and liquid,with the benefit it can make more accurate diagnosis in a timely manner,thus to provide important clinical value for clinical diagnosis,cure the disease in a short time,and reduce patient pain,which is worth clinical promotion.