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目的:探讨阑尾术后肠粘连气腹造影的CT影像特征及其临床价值.方法:20例术后慢性腹痛,腹胀或有机械性肠梗阻反复发作的疑诊阑尾手术后肠粘连患者.采用深静脉穿刺导管或18号软套管针注气后行腹部CT扫描,对影像特征进行解析、分类.结果:2例患者(因急诊)未行该检查,2例患者行该检查未成功,16例患者均表现有腹壁粘连的影像特征,腹内脏器局部隆起,跨越气腹空间与腹壁贴附.粘连的脏器有大网膜、小肠、结肠.根据粘连的脏器及范围可分为局限性大网膜粘连10/16(62.5%)、局限性肠管粘连5/16(31.3%)和全腹弥漫性粘连1/16(0.7%).其中9例患者行经腹腔镜肠粘连松解术,2例行腹腔镜部分松解术结合小切口开腹手术,2例急诊行剖腹探查术(其中1例表现有网膜粘连,另1例无粘连).手术患者与气腹造影腹部CT平扫结果完全一致.结论:气腹造影CT检查安全、简便易行,多平面重建图有助于腹壁粘连的直观显示.
Objective: To investigate the CT features and clinical value of postoperative appendix gastrectomy pneumoperitoneum.Methods: Twenty patients with postoperative intestinal obstruction were treated with chronic abdominal pain, abdominal distension or repeated mechanical intestinal obstruction. Venous puncture catheters or 18 soft trocars were used to perform abdominal CT scan to analyze and classify the imaging features.Results: 2 patients (due to emergency) did not do this test, 2 patients did not succeed in this test, 16 Patients showed abdominal adhesions of the image features, abdominal organs uplift, abdominal space across the abdominal wall and attached. Adhesion of the organs omental, small intestine, colon. According to the visceral organs and the range can be divided into limitations (16.5%), 5/16 (31.3%) localized diffuse adhesions and 1/16 (0.7%) diffuse entire abdominal adhesions, of which 9 patients underwent laparoscopic gut adhesion lysis , 2 cases of laparoscopic partial lysis combined with small incision laparotomy, 2 cases of emergency laparotomy (one case showed omental adhesions and the other without adhesions.) Operative patients with pneumoperitoneum abdominal CT level Scan the results exactly the same.Conclusion: pneumoperitoneum CT scan safe, easy, multi-planar reconstruction map Help visualize abdominal adhesions.