CT判断小肠梗阻是否需手术治疗的相关分析

目的 探讨CT对判断小肠梗阻是否出现肠坏死需要手术治疗的作用.方法 回顾性分析2010年6月至2012年5月手术治疗以及术前经过CT检查的72例成人小肠梗阻的临床资料.结果 纳入分析的72例患者,手术证实为闭袢型或绞窄型肠梗阻,分为肠坏死组（54例）与无肠坏死组（18例）.肠坏死组中48例有腹腔游离积液（88.9%）,40例有肠系膜血管束呈放射状分布（74.1%）.无肠坏死组中4例发现腹腔游离积液（22.2%）,3例呈肠系膜血管束放射状分布（16.7%）.结论 CT如发现腹腔游离积液及肠系膜血管束呈放射状分布提示肠坏死,对判断适时手术探查有积极意义.

Evaluation of surgical treatment for small bowel obstruction by CT findings

Objective To evaluate the necessity of surgical treatment for necrotic small bowel obstruction by computed tomographic （CT） findings. Methods Seventy-two patients admitted from June 2010 to May 2012 at Futian People＇s Hospital of Shenzhen（China） with surgically confirmed closed loop and strangulating obstruction were divided into two groups （necrosis group, n = 54） and （non-necrosis group,n = 18）. The differences in CT findings between the two groups were compared on the basis of free intraperitoneal fluid and radial distribution of the mesenterie vessels. Results Of the 54 patients with intestinal necrosis, 48 patients had free intraperitoneal fluid and 40 patients had radial distribution of the mesenteric vessels on CT. Of the 18 patients in non-necrosis group, 4 pa- tients had free intraperitoneal fluid and 3 patients had radial distribution of the mesenteric vessels on CT. Conclusion Free intraperitoneal fluid and radial distribution of the mesenteric vessels earl well predict the presence of intestinal necrosis in patients with closed loop and strangulating obstruction of the small bowel.