CT在急性阑尾炎严重度评价中应用价值.docVIP

CT在急性阑尾炎严重度评价中应用价值 　　[摘要] 目的 探讨CT在急性阑尾炎严重程度评估中的应用价值。 方法 连续性选择本院2015年9月1日～2016年12月31日术前行CT检查的急性阑尾炎患者34例。对病例CT征象、手术表现及病理变化等资料进行分析。从正常阑尾到阑尾炎伴阑尾周围脓肿或炎性包块分六级对CT和手术-病理报告进行评价，并对CT分级和手术-病理分级的相关性及其临床资料进行统计学分析。 结果 CT分级中位数3（四分位间距2-4），手术-病理分级中位数3（四分位间距2-4）。CT分级与手术-病理分级诊断完全符合率64.7%。CT和手术-病理分级成正相关（rs=0.88，P0.01）。 结论 急性阑尾炎的CT征象与病理变化分级成正相关，依据CT征象对急性阑尾炎的严重程度进行分级诊断有较高的应用价值，对指导阑尾炎治疗有益。 　　[关键词] 急性阑尾炎；X线体层摄影术；分级诊断；治疗 　　[中图分类号] R656.8 [文?I标识码] A [文章编号] 2095-0616（2017）13-139-03 　　[Abstract] Objective To explore the application value of CT in the evaluation of acute appendicitis severity. Methods 34 patients with acute appendicitis underwent CT examination from September 1，2015 to December 31，2016 in our hospital were selected.The data of CT signs，surgical findings and pathological changes were analyzed.The CT and surgical pathology reports were evaluated from normal appendix to appendicitis with appendiceal abscess or inflammatory mass in six grades.The correlation between CT classification and operation pathological classification and clinical data were statistically analyzed. Results The median CT score was 3 （four，2-4 spacing），and the median surgical pathology score was 3 （four，2-4 spacing）.The CT classification was in accordance with the operation pathological grading，with a rate of 64.7%.CT was positively correlated with surgical pathological grading（rs=0.88， P0.01）. Conclusion The CT signs of acute appendicitis are positively correlated with pathological changes.Grading the diagnosis of acute appendicitis according to CT signs is of high value and helpful for the treatment of appendicitis. 　　[Key words] Acute appendicitis；X-ray tomography；Grading diagnosis；Treatment 　　急性阑尾炎是最常见的急腹症，主要的治疗方法是外科手术治疗。随着外科技术的进步，大部分阑尾炎通过腹腔镜手术切除，但是部分患者仍然需要中转开腹手术切除，特别是伴有阑尾周围积液、脓肿或感染性包块者[1-3]。可见临床对影像的需求不仅是疾病诊断和鉴别诊断，也应包括治疗指导。随着CT技术的发展，特别是多层螺旋CT的问世，CT图像所显示的征象越来越接近病理变化[4]。术前CT检查不仅有利于帮助临床医师选择治疗方法，也有助于手术医生了解术中可能遇到的困难[2，5-6]。本文回顾分析34例阑尾炎患者的CT征象、手术表现及病理变化，探讨CT在急性阑尾炎严重程度评价中的应用价值，期望提高CT在指导急性阑尾炎治疗中的作用。 　　1 资料与