直接CT征象判断穿孔型阑尾炎的可行性观察

摘要

Objective To observe the feasibility of direct CT signs in judging perforated appendicitis.Methods 90 patients with acute appendicitis confirmed by surgery and pathology in our hospital from January 2012 to January 2015 were selected as the research objects, and divided into perforated group (n=36) and nonperforated group (n=54) according to the types of appendicitis.Both two groups underwent CT examination.The CT signs of perforated appendicitis were summarized and the diagnostic value was evaluated.Results There were 10 cases of gas perforation outside of the cavity in perforated appendicitis, 6 cases of peripheral cysts, 18 cases of localized enhancement defects, 24 cases of changes of pelvic inflammatory disease, 36 cases of mild to moderate peripheral inflammation and 30 cases of moderate to severe peripheral inflammation, with statistically significant differences compared with non-perforated group (P＜0.05).The diagnostic value of moderate to severe appendicular peripheral inflammation signs in perforated appendicitis was the highest, the sensitivity, specificity and accuracy were all 83.3％, with high comprehensive value.Conclusions Stercorolith outside of the appendix cavity, gas outside of the cavity, localized enhancement defects on appendicular wall, peripheral abscess and peripheral inflammation are specific signs of perforated appendicitis, but the application value of multi-sign combined diagnosis in judging perforated appendicitis is higher.%目的 观察直接CT征象判断穿孔型阑尾炎的可行性.方法 选取2012年1月至2015年1月于我院经手术及病理证实为急性阑尾炎的90例患者作为研究对象,按其阑尾炎分型将其分为穿孔型组(n=36)与非穿孔型组(n=54),两组均接受CT检查,总结穿孔型阑尾炎CT征象,评估其诊断价值.结果 穿孔型阑尾炎腔外气体穿孔10例,周围囊肿6例,局限性强化缺损18例,盆腔炎改变24例,轻中度周围炎36例,中重度周围炎30例,与非穿孔组比较差异有统计学意义(P＜0.05);阑尾中重度周围炎征象判断穿孔型阑尾炎诊断价值最高,其敏感性、特异性、准确率均为83.3％,综合价值高.结论 阑尾腔外粪石、腔外气体、阑尾壁局限性强化缺损、周围脓肿、周围炎症均为穿孔型阑尾炎的特异性征象,但多征象联合诊断鉴别穿孔型阑尾炎应用价值更高.