血吸虫性阑尾病变的超声声像特征探讨

目的探讨血吸虫性阑尾病变的超声声像特征。方法在2012年1月-2015年12月湖州市中心医院经彩超发现的血吸虫性肝病患者中,选择有明确血吸虫病病史及治疗史的患者50例作为血吸虫性肝病组,并选取50例未发现血吸虫性肝病,且来自非血吸虫病流行区、无血吸虫病病史的普通人群作为对照组,对两组行右下腹阑尾超声扫查。采集两组阑尾最大直径、阑尾壁最厚厚度,并观察阑尾壁回声是否均匀等。结果血吸虫性肝病组阑尾腔最小内径为(2.090±0.790)mm,小于对照组;阑尾壁最厚厚度为(1.332±0.313)mm,大于对照组,差异均有统计学意义(t=2.647、-4.526,P均0.05)。血吸虫性肝病组阑尾壁回声欠均匀、结构欠清晰、不均匀增厚者比例以及阑尾腔内有肠内容物者比例均高于对照组(χ~2=12.000、18.537、24.008、4.244,P均0.05)。结论血吸虫性阑尾病变在超声下具有明显的声像特征,超声在判断血吸虫病患者阑尾是否遭受累及,及早发现阑尾病变中有很大价值。

Discussion on ultrasonographic characteristics of schistosomal appendicitis lesions

Objective To discuss the ultrasonographic characteristics of schistosomal appendicitis lesions. Methods Among the patients with schistosomal hepatopathy who were discovered by Color Doppler ultrasound in Huzhou Central Hospital from January 2012 to December 2015， 50 cases with clear history of schistosomiasis and treatment were chosen as a schistosomal hepatopathy group， meanwhile， 50 normal people， who came from non?endemic areas， without schistosomal hepatopathy and schistosomiasis history were chosen as a control group. The two groups were examined by ultrasound scan of the appendix， and the data of the largest diameter of the appendix and the thickness of the appendix wall were collected， and the sonographic characteristics of their appendixes， such as whether the echo of the appendix wall was even or not， were observed. Results The minimum internal diameter of the appendix cavity and the thickness of the appendix wall of the schistosomal hepatopathy group were （2.090 ± 0.790） mm and （1.332 ± 0.313） mm ， respectively， the former was significantly narrower than that of the control group， while the latter was significantly thicker than that of the control group （t = 2.647， - 4.526， respectively， both P＜0.05）. The proportions of those with inhomogeneous echo， indistinctness structure， uneven thickening of the appendix wall， as well as having intestinal contents in the appendix cavity in the schistosomal hepatopathy group were higher than those in the control group（χ2]= 12.000， 18.537， 24.008， 4.244， respectively， all P＜0.05）. Conclusions Schistosomal appendicitis lesions have obvious ultrasonographic characteristics under ultrasound. Ultrasound can play an important role in judging whether the appendix of schistosomiasis patients is involved and discovering the lesion of appendix early.