超声引导下腹腔注入平衡液对术后腹腔粘连的检测

目的运用超声导向下腹腔注入平衡液对术后腹腔粘连进行检测与定位研究.方法根据粘连常见病因(大出血和感染),将20只大鼠随机分两组:大出血组(A组)和感染组(B组),于术后14 d应用超声导向下腹腔注入平衡液,使用高频探头进行多方位扫查,对腹腔粘连进行检测和定位,记录结果,录像摄片.14 d后处死,尸解观察,和手术结果进行对照.结果超声描述了总共71处腹腔内粘连,40处(56.3%)在下腹部,粘连最常见的类型位于前腹壁和肠管(n=19,27%)和邻近肠管间(n=18,25%),和术后结果相比,敏感性为81%,特异性59%.在描述腹壁和脏器之间(18/19,94.7%)和邻近肠管之间粘连(18/20,90.0%),超声过高地估计肝脏、脾脏与肠管间粘连,可能忽略腹壁与大网膜、大网膜与小肠之间粘连.结论此技术可以对术后粘连部位和类型进行诊断,超声可作为对术后腹腔粘连诊断一种手段.

Detection and Mapping of Intra-peritoneal Adhesions by Ultrasound Guided Injection of Sodium Lactate Ringer's Solution

Objective To evaluate the clinical value of using ultrasonography for detection and mapping postoperative intra peritoneal adhesions by injecting sodium lactate Ringer solution(SLR) in the abdominal cavity.Methods Twenty rats were divided randomly into two groups and operated on the basis of adhesion common causes: the massive bleeding group(group A) and the infective group(group B) On the fourteenth day after operation,every rat was injected with 389 ml/kg of SLR in the abdominal cavity guided by ultrasound,scanned with a high frequency transducer in different longitudinal and transverse planes and the intra abdominal adhesion was detected and mapped The results were recorded by video and photography All the rats were anatomized after 14 days All the sonographic findings were compared with postoperative results.Results There were a total of 71 adhesions depicted by ultrasonography,of which 40 adhesions(56 3%) were in the lower abdomen The common types of adhesions located between ventral abdomen wall and bowel loops( n =19,27%),and between adjacent bowel loops( n =18,25%) Comparison with operative results showed a sensitivity of 81% and a specificity of 59% Ultrasonic imaging detection was most accurate in depicting adhesions at the sites between abdomen wall and bowel(94 7%,18/19),or at the sites between adjacent bowel(90%,18/20),Adhesions were overestimated at the sites between liver and bowel loops,spleen and bowel loops.Moreover,adhesions may be missed at the sites between ventral and greater omentum,greater omentum and intestine.Conclusions The ultrasonic findings of the type and site for postoperative adhesions demonstrated that the ultrasonic diagnosis of postoperative adhesions is feasible Ultrasound plays an important role in detection of postoperative adhesions.