超声在急性腹腔积液定位穿刺中应用及诊断分析.docVIP

超声在急性腹腔积液定位穿刺中应用及诊断分析 　　摘要：目的探讨超声在急性腹腔积液定位穿刺中的应用及诊断价值。方法回顾26例急性腹腔积液定位穿刺中的超声应用及声像图诊断分析。结果26例急性腹腔积液定位穿刺，穿刺液为血性17例，穿刺液混浊或脓性9例，经手术及相关治疗证实，符合率约为88%。结论超声可根据腹腔积液的部位、积液量迅速确定最佳穿刺部位，根据穿刺液的性质为临床提供初步诊断，对急诊疾病的诊断及治疗有重要意义。 　　关键词：超声；急性腹腔积液；定位穿刺；应用；诊断 　　Application of Ultrasound in Acute Abdominal Cavity Effusion Puncture 　　XIE Xue-chun 　　(Lingshan County Hospital of traditional Chinese Medicine,Qinzhou 535400,Guangxi,China) 　　Abstract：Objective This research is to investigate the application and diagnostic value of ultrasound in acute peritoneal effusion positioning puncture .MethodsBased on 26 cases of application and sonogram diagnosis of ultrasound in acute peritoneal effusion positioning puncture. Among these 26 cases,it is found that there are 17 cases of bloody puncture fluid and 9 cases of puncture fluid are turbid and purulent.Confirmed by surgery and related treatment,the accuracy rate reaches about 88%.Results26 cases of acute peritoneal effusion puncture, puncture fluid is bloody puncture 17 cases, cloudy or purulent fluid in 9 cases, after operation and related therapy, the coincidence rate is about 88%. Conclusion Ultrasound according to peritoneal effusion site, the amount of fluid to quickly determine the best puncture site, provides a preliminary diagnosis of clinical character according to puncture fluid, has an important significance in diagnosis and treatment of acute disease. 　　Key words：Ultrasound；Acute peritoneal effusion；Positioning Puncture；Application；Diagnosis 　　1资料与方法 　　1.1一般资料对我院超声检查发现急性腹腔积液病例26例进行分析，男16例，女10例，年龄10~70岁，所有患者均住院经手术及临床治疗证实。 　　1.2方法采用ALKA-3500超声诊断仪，探头频率为3.5MHZ及7~10MHZ。根据病情采用适合体位对腹腔脏器进行全面检查，对于肝肾隐窝、脾肾隐窝、双侧髂窝、子宫直肠窝及直肠间隙进行重点扫查。探查到积液时注意积液的部位及量，并选出最佳穿刺点、穿刺方向及深度，作出体表标志进行诊断性穿刺。腹腔诊断性穿刺的穿刺点：①于脐和髂前上棘连线的中、外1/3交界处；②经脐水平线与腋前线相交处；③脐与耻骨联合连线的中点上方1.0cm，稍偏左或偏右1.0～1.5cm处。腹腔穿刺抽到液体后，观察穿刺液性状，借以推断哪类脏器受损，肉眼观察不能肯定其性质时，应做相应实验室检查。 　　2结果 　　2.1本组26例急性腹腔积液患者中，穿刺液为血性17例：其中脾破裂4例，肝破裂2例，宫外孕8例，黄体破裂3例；穿刺液混浊呈脓性9例：其中急性胃肠道穿孔3例，急性阑尾炎5例，急性胰腺炎1例。经手术及临床验证，诊断符合率为88%。由此可见，利用超声引导抽液，根据患者