CT与X线诊断肠梗阻的临床价值探讨

目的：探讨腹部X线与CT扫描鉴别急性肠梗阻的准确性，为临床诊断提供参考。方法：选取2011年8月-2013年8月我院收治的66例急性肠梗阻患者的临床资料进行回顾分析。所有患者均经手术活检或病理诊断证实为急性肠梗阻。术后患者均行腹部X线及CT扫描检查，对两种方法判断肠梗阻的发生、梗阻部位、类型及病因与手术病理结果进行比较，评价并分析两种检查方法的准确率。结果：66例肠梗阻患者中，X线检出率为89．39％，CT检出率为95．45％。X线诊断小肠梗阻准确率为72．10％，CT为86．05％；X线诊断结肠梗阻准确率为69．57％，CT为86．96％。X线诊断肿瘤准确率为69．57％，CT为86．96％；X线诊断肠粘连准确率为67．86％，CT为82．14％；X线诊断肠套叠准确率为60．00％，CT为80．00％；X线诊断单纯性机械性肠梗阻准确率为78．72％，CT为82．98％；X线诊断绞窄性肠梗准确率为73．68％，CT为78．95％。CT对肠梗阻部位、病因及类型的诊断准确率高于腹部X线片，差异具有统计学意义（P〈0．05）。结论：腹部X线与CT用于诊断急性肠梗阻具有较高的准确率，但CT对于肠梗阻部位、梗阻类型及梗阻病因的诊断优于X线片。

Clinical Value of the CT and the X Ray on the Diagnosis of the Intestinal Obstruction

Objective： To study the value of the X ray and CT on the diagnosis of the intestinal obstruction in order to make a reference to the clinical treatment. Methods： A retrospective analysis of the clinical data of 66 patients with the intestinal obstruction who were treated in our hospital from August 2011 to 2013 was performed. All the patients were confirmed the acute intestinal obstruction by the surgical biopsy or the pathology. The X-ray and CT scan were used to diagnose the etiology, the position and the types of the intestinal obstruction. The results of the two methods were compared with the pathology. Then the diagnostic accuracy of the two methods was evaluated and analyzed. Results： 66 patients were confirmed the intestinal obstruction. The detection rate of X-ray was 89.39% which was lower than 95.45% of the CT （P〈0.05）. The diagnosis of the small intestinal obstruction by the X-ray was 72.10% which was lower than 86.05% of the CT （P〈0.05）; The diagnosis of the slice junction obstruction by the X-ray was 69.57% which was lower than 86.96% of the CT （P〈0.05）; The diagnosis of the tumor was 69.57% which was lower than 86.96% of the CT （P〈0.05）; The diagnosis of the intestinal adhesion by the X ray was 67.86% which was lower than 82.14% of the CT （P〈0.05）; The diagnosis of the intussusception by the X-ray was 60.00% which was lower than 80.00% of the CT （P〈0.05）; The diagnosis of the simple mechanical intestinal obstruction by the X-ray was 78.72% which was lower than 82.98% of the CT （P〈0.05）; The diagnosis of the strangulation bowel infarction by the X-ray was 73.68% which was lower than 78.95% of the CT （P〈0.05）. There were statistically significant differences about the etiology, the types and the position of the intestinal obstruction （P〈0.05）. Conclusion： The diagnostic rate of the acute intestinal obstruction by the X-ray and CT could be accurate. It is suggested that the clinical value of the CT on the diagnosis of the intestinal obstruct