X线与超声联合诊断在抗精神病药物致麻痹性肠梗阻中的应用

目的 探讨X线与超声联合诊断在抗精神病药物致麻痹性肠梗阻中的应用.方法 回顾性分析124例抗精神病药物致麻痹性肠梗阻患者的X线和超声检查资料,分析其影像学表现和诊断符合率.124例均行立位腹部X线平片和透视检查,其中68例同时行B超检查.结果 X线诊断符合率为87.9%(68/68),漏诊率为12.1%(15/124);超声诊断符合率为82.4%(56/68),漏诊率为17.6%(12/68);两者诊断符合率和漏诊率比较差异无统计学意义(P＞0.05).X线联合超声检查的诊断符合率为100.0%(68/68),无一例漏诊,与单独应用X线及超声检查诊断符合率及漏诊率比较差异有统计学意义(P＜0.05).结论 X线检查是诊断抗精神病药物致麻痹性肠梗阻的首选方法,超声检查对肠腔积液的发现具有优越性,两者结合能够提高诊断符合率.

The diagnosis of paralytic intestinal obstruction caused by antipsychotic agents with X-ray combined with ultrasound

Objective To explore the images and diagnostic evaluation of X-ray combined with ultrasound in paralytic intestinal obstruction caused by antipsychotic agents. Methods The data of X-ray and ultrasound of 124 cases of clinically diagnosed paralytic intestinal obstruction caused by antipsychotic agents were analyzed retrospectively, as well as their rates of confirmed diagnosis. All the 124 patients were examined by erect abdominal radiography and fluoroscopy,68 of the 124 patients by ultrasound. Results According to their typical images,the rate of X-ray confirmed diagnosis was 87.9%(109/124) with 15 missed diagnosis and the rate of missed diagnosis was 12.1%( 15/124);the rate of ultrasound confirmed diagnosis was 82.4%(56/68) with 12 missed diagnosis and the rate of missed diagnosis was 17.6%(12/68). There was no significant difference between X-ray and ultrasound (P＞ 0.05 ). Compared with X-ray or ultrasound ,X-ray combined with ultrasound in the diagnosis of paralytic intestinal obstruction could increase the rate of confirmed diagnosis (100.0% ,68/68),and decrease the rate of missed diagnosis (0),the difference was statistically significant (P＜ 0.05 ). Conclusions X-ray examination is the first choice to diagnose paralytic intestinal obstruction caused by antipsychotic agents,but ultrasound has the advantage of finding fluid in abdominal cavity. To reduce missed diagnosis, X-ray should be combined with ultrasound.