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目的总结慢性胆囊炎的临床表现探讨二维超声诊断在该疾病中的临床应用价值。方法选取河南省焦作市博爱县计划生育服务站于2014年6月-2015年2月收治的84例慢性胆囊炎患者为研究对象,回顾性分析其病历资料,总结其临床表现;对所有受试者予以二维超声及三维超声检查,记录诊断符合率。应用统计学软件SPSS 19.0分析数据,计数资料以百分率表示,采用χ2检验,P<0.05为差异有统计学意义。结果184例受试者临床表现多呈不典型性;全身症状以低热、乏力、头晕、关节痛等发生率较高,分别为53.57%、36.90%、33.33%和32.14%;消化道症状以右上腹隐痛发生率较高,为47.62%;284例受试者中胆囊大小正常者55例(65.48%),胆囊肿大20例(23.81%),胆囊萎缩9例(10.71%);二维超声显示囊壁光滑、连续,回声未见异常,但胆汁内壁可见中弱回声者10例(11.90%),胆汁回声正常但囊壁可见高回声光团附着或弱回声17例(20.24%),囊壁回声增强且呈弥漫性均匀增厚57例(67.86%);胆汁透声良好5例(5.95%),胆部透声欠佳且可见弱回声66例(78.57%),胆汁暗区透声差且可见光点回声13例(15.48%);84例受试者二维超声诊断结果显示诊断符合率为80.95%(68/84),漏诊率为4.76%(4/84),误诊率为15.48%(13/84);三维超声诊断结果显示诊断符合率为97.62%(82/84),漏诊率为0,误诊率为3.57%(3/84),两种检查方案对比差异具有统计学意义(P<0.05)。结论慢性胆囊炎患者多呈不典型临床表现;仅将二维超声检查作为慢性胆囊炎的诊断手段,误诊或漏诊风险较高,建议联合患者临床表现及其他检查手段以提升诊断准确性及有效性,为后续治疗工作的顺利开展提供条件。
Objective To summarize the clinical manifestations of chronic cholecystitis to explore the value of two-dimensional ultrasonography in the clinical application of the disease. Methods A total of 84 patients with chronic cholecystitis who were treated at Family Planning Service Station in Bo’ai County, Jiaozuo City, Henan Province from June 2014 to February 2015 were selected as the research objects. The medical records of the patients were retrospectively analyzed and the clinical manifestations were summarized. To be two-dimensional ultrasound and three-dimensional ultrasound, record the diagnostic accuracy. Statistical analysis software SPSS 19.0 was used to analyze the data. Counting data were expressed as a percentage, usingχ2 test, P <0.05 was considered statistically significant. Results The clinical manifestations of 184 patients were mostly atypical. The incidence of systemic symptoms such as fever, fatigue, dizziness and arthralgia were higher, accounting for 53.57%, 36.90%, 33.33% and 32.14% respectively. The upper gastrointestinal symptoms The incidence of abdominal pain was high (47.62%). Among the 284 subjects, 55 (65.48%) had normal gallbladder size, 20 (23.81%) had gallbladder enlargement and 9 (10.71%) had gallbladder atrophy. 10 cases (11.90%) showed moderate to weak echoes in the inner wall of bile, 17 cases (20.24%) showed biliary echo normal, but the echogenicity of the echogenic mass was observed in the cyst wall, The echogenicity of the capsule wall was diffuse and uniform thickening in 57 cases (67.86%). The bile permeability was good in 5 cases (5.95%), the bile permeability was poor and the weak echo was seen in 66 cases (78.57% 13 cases (15.48%) had acoustic aberration and visual point echoes. The two-dimensional ultrasound diagnosis results of 84 subjects showed that the diagnostic coincidence rate was 80.95% (68/84) and the missed diagnosis rate was 4.76% (4/84). The misdiagnosis rate was 15.48% (13/84). The three-dimensional ultrasonography showed that the diagnostic coincidence rate was 97.62% (82/84), the rate of misdiagnosis was 0 and the rate of misdiagnosis was 3.57% (3/84). There was statistically significant difference between the two examinations Significance (P <0.05). Conclusions Patients with chronic cholecystitis often have atypical clinical manifestations. Two-dimensional ultrasonography is only used as a diagnostic tool for chronic cholecystitis, and the risk of misdiagnosis or misdiagnosis is high. It is suggested that clinical manifestations and other tests should be combined to improve diagnostic accuracy and effectiveness , Provided the conditions for the smooth implementation of follow-up treatment.