陈宝强内蒙古赤峰市喀喇沁旗医院超声科，内蒙古赤峰　024000

外伤性胃肠穿孔应用超声诊断的临床价值研究

陈宝强
内蒙古赤峰市喀喇沁旗医院超声科，内蒙古赤峰024000

目的探究超声诊断在外伤性胃肠道穿孔中的临床应用价值。方法总结性分析2010年1月—2015年1月近5年来收治的99例胃肠道穿孔患者术前超声检测和X线检查情况，比较两种不同影像学方法外伤性胃肠穿孔的检出率，腹腔游离气体检出率和定位准确率。结果①超声定位准确率为82.8%，X线不具有诊断能力；②超声的腹腔游离气体检出率52.5%明显低于X线的检出率71.7%，具有统计学意义；③外伤性胃肠穿孔超声诊断率87.9%显著高于X线检出率71.7%。术者对术前超声的满意程度高于对X线的满意程度，差异有统计学意义（P＜0.05）。结论超声在检测腹腔游离气体时效果不及X线检测，但是在外伤性胃肠道穿孔诊断和定位方面优于X线平片。综合分析超声在诊断胃肠道穿孔中具有可观的临床价值。

外伤性胃肠道穿孔；超声；诊断；临床价值

［Abstract］Objective Explore the clinical value of ultrasound diagnosis of traumatic perforation of the gastrointestinal tract.Methods Summary Analysis January 2010—January 2015 admitted to the past five years 99 cases of gastrointestinal perforation in patients with preoperative ultrasound and X-ray inspection，comparing two different imaging methods traumatic gastrointestinal perforation detection rate intraperitoneal free gas detection rate and positioning accuracy.Results①ultrasonic positioning accuracy was 82.8%，X does not have a line diagnostic capabilities；②free intraperitoneal air ultrasonic detection rate was significantly lower than the 52.5%of the X-ray detection rate 71.7%，with statistical significance；③ultrasound diagnosis of traumatic gastrointestinal perforation rate of 87.9%was significantly higher than that of X-ray detection rate of 71.7%.Surgeon preoperative ultrasound level of satisfaction is higher than the level of satisfaction of the X-ray，it was statistically significant（P＜0.05）.Conclution Ultrasound in detecting free intraperitoneal gas effect is less than X-ray detector，but better than the X-ray in the diagnosis of traumatic gastrointestinal perforation and positioning.Comprehensive analysis of ultrasound has considerable clinical value in the diagnosis of gastrointestinal perforation.

［Key words］Traumatic gastrointestinal perforation；Ultrasound；Diagnosis；Clinical Value

外伤性胃肠道穿孔是外科较为常见的急腹症之一，主要有坠落伤，车祸伤，刀刺伤或碰撞挤压伤引起，外伤引起的胃肠道穿孔病理机制尚不清楚，但是该病较凶恶。穿孔时主要临床表现为突然发生上腹部剧烈疼痛，呈持续性刀割样或烧灼样痛，很快扩散到全腹；常伴有出汗。四肢冰冷、心慌、气短等休克现象；可有恶心呕吐、腹胀、发热。病者呈急性病容，腹式呼吸消失或减弱，全腹有压痛、反跳痛及肌紧张，上腹部与右下腹部明显。……