摘要
目的分析不典型消化道穿孔的临床特点,提高诊断率。方法回顾分析术后确诊为消化道穿孔患者90例,总结其腹痛时间、部位、程度,以及腹部X线、CT、超声等影像学检查特点,评价各项指标的临床诊断意义。结果 90例中表现为典型急腹痛者35例(38.89%),板状腹者28例(31.11%),老年人较中青年缺乏典型体征(P<0.01)。79.55%(70例/88例)在腹部X片中发现膈下游离气体,低于CT检查的83.33%(15例/18例),差异有统计学意义(P<0.05)。诊断性腹穿成功率为73.33%(11例/15例),阳性率为72.72%(8例/11例)。结论不典型消化道穿孔,其临床症状、体征多缺乏特异性,腹部X线及CT检查为诊断所必需,结合诊断性腹穿可提高诊断率。
Objective To analyze the clinical features of atypical digestive tract perforation in order to increase its diagnostic rate.Methods Time,location and extent of abdominal pain,and its characteristics found at X-ray,CT and ultrasound examinations in 90 patients with digestive tract perforation diagnosed after operation were retrospectively analyzed and their clinical diagnostic value was evaluated.Results Of the 90 patients,35（38.89%） had typical acute abdominal pain,28（31.11%） had wooden belly.Typical signs were less in old patients than in young patients（P0.01）.Abdominal X-ray showed free air in sub-diaphragm of 70（73.33%） out of the 88 patients while CT revealed free air in sub-diaphragm of 8（83.33%） out of 11 patients（P0.05）.The success rate of diagnostic peritoneocentesis was 73.33%（11 out of 15 patients） with a positive rate of 72.72%（8 out of 11 patients）.Conclusion The clinical symptoms and signs of atypical digestive tract perforation are lack of specificity.Abdominal X-ray and CT in combination with diagnostic peritoneocentesis can improve its diagnostic rate.
出处
《军医进修学院学报》
CAS
2011年第8期808-809,843,共3页
Academic Journal of Pla Postgraduate Medical School
关键词
不典型消化道穿孔
临床诊断
腹部X片
诊断性腹穿
Atypical Digestive Tract Perforation
Clinical Diagnosis
Abdominal X-ray
Diagnostic Abdominal Paracentesis
