摘要
目的:分析急腹症患者的超声表现及临床超声误诊的原因。方法:选取我院2012年4月至2017年5月期间收治的100例急腹症患者,均行彩色多普勒超声检查,根据超声图像特征进行分类,判断急腹症疾病类型,并与手术病理学诊断结果进行对比,分析超声对急腹症疾病类型诊断的准确率及误诊率,同时分析误诊原因。结果:根据超声显示的病灶位置、大小、回声、血流图像等特征分类,发现不同病因等导致的急腹症患者超声表现特征明显,100例急腹症患者经术后病例诊断泌尿系结石19例,肝、胆结石18例,急性阑尾炎15例,急性胆囊炎11例,急性胰腺炎10例,肠梗阻10例、肠穿孔12例,异位妊娠、卵巢扭转各5例,腹部大血管疾病1例,超声诊断准确率为84.00%,误诊率为16.00%,误诊患者中,2例泌尿系结石误诊为慢性结肠炎和肠梗阻;1例胆结石误诊为肠息肉;1例急性阑尾炎误诊为泌尿系结石;2例急性胆囊炎误诊为胆结石和胆汁淤积;1例急性胰腺炎误诊为肠瘘;1例肠梗阻、1例肠穿孔误诊为急性阑尾炎;2例异位妊娠误诊为化脓性阑尾炎和早孕,3例卵巢扭转误诊为化脓性阑尾炎、阑尾穿孔、早孕;1例腹部大血管疾病误诊为宫外孕。超声误诊的原因主要包括超声显示不佳、未见明显征象、超声表现不典型或与其他疾病类似等。结论:多普勒超声诊断急腹症的准确率较高,但受超声显示不佳、未见明显征象、超声表现不典型等的限制仍可出现误诊,临床应辅助其他方式尽早鉴别诊断。
Objective： To analyze the ultrasonic findings of acute abdominal diseases and the causes of misdiagnosis. Methods： 100 cases of patients with acute abdominal diseases treated in our hospital from April2012 to May 2017 were selected and examined with color Doppler ultrasonography. According to the features of ultrasonic images,the types of acute abdominal diseases were diagnosed,and the results were compared with the diagnosis results of operation and pathology. The accuracy and misdiagnosis rate of ultrasonic diagnosis of acute abdominal diseases,and the causes of misdiagnosis were analyzed. Results： According to the sites,size,echo and blood flow images of lesions displayed by ultrasound,it was found that the ultrasonic findings of patients with acute abdominal diseases caused by different causes were obvious. The postoperative pathological diagnosis of 100 patients with acute abdominal diseases showed 19 cases of urinary calculi,18 cases of hepatic stones and gallstones,15 cases of acute appendicitis,11 cases of acute cholecystitis,10 cases of acute pancreatitis,10 cases of intestinal obstruction,12 cases of intestinal perforation,5 cases of ectopic pregnancy and ovarian torsion,and 1 case of abdominal large vascular disease. The accuracy rate of ultrasonic diagnosis was84.00%,and the misdiagnosis rate was 16.00%. Among the misdiagnosed patients,there were 2 cases of urinary calculi misdiagnosed as chronic colitis and intestinal obstruction,1 case of gallstone misdiagnosed as intestinal polyps,1 case of acute appendicitis misdiagnosed as urinary calculi,2 cases of acute cholecystitis misdiagnosed as gallstones and cholestasis,1 case of acute pancreatitis misdiagnosed as intestinal fistula,1 case of intestinal obstruction and 1 case of intestinal perforation misdiagnosed as acute appendicitis,2 cases of ectopic pregnancy misdiagnosed as purulent appendicitis and early pregnancy,3 cases of ovarian torsion misdiagnosed as purulent appendicitis,appendix perforation and early pregnancy,and 1 case of abdominal large vascular disease misdiagnosed as ectopic pregnancy. The causes of misdiagnosis mainly includes poor ultrasonic findings,non obvious signs,atypical ultrasonic features or similar diseases. Conclusion： The accuracy rate of Doppler ultrasound is high in the diagnosis of acute abdominal diseases. However,poor ultrasonic findings,non obvious signs and atypical ultrasonic features may cause misdiagnosis. Other ways can be used for differential diagnosis.
作者
王丽
汪旭
WANG Li;WANG Xu(Xiangyang Central Hospital,Hubei Xiangyang 441021,China)
出处
《河北医学》
CAS
2018年第6期961-966,共6页
Hebei Medicine
基金
湖北省自然科学基金项目
(编号:2013BD0145)
关键词
急腹症
多普勒超声
误诊
鉴别诊断
Acute abdominal diseases
Doppler uhrasound
Misdiagnosis
Differential diagnosis
作者简介
通讯作者：汪旭
