急诊CT血管成像在急腹症中的应用价值
投稿时间:2016-09-18  修订日期:2016-09-21  点此下载全文
引用本文:朱玉秀,李桢,韩世瑜,徐丽.急诊CT血管成像在急腹症中的应用价值[J].医学研究杂志,2017,46(9):175-178
DOI: 10.11969/j.issn.1673-548X.2017.09.045
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作者单位E-mail
朱玉秀 100076 北京航天总医院 13681584989@qq.com 
李桢 100076 北京航天总医院  
韩世瑜 100076 北京航天总医院  
徐丽 100076 北京航天总医院  
中文摘要:目的 探讨急诊CT血管成像在急腹症患者中的临床应用价值。方法 分析16例以急性腹痛为主要表现、临床首诊误诊并行CTA检查确诊的患者资料。结果 血管源性急腹症的误诊率为43.2%(16/37),腹主动脉夹层6例,其中累及肠系膜上动脉者3例,累及腹腔干2例;单纯肠系膜上动脉夹层1例;腹主动脉壁间血肿2例;肠系膜上静脉血栓3例,其中合并门静脉及脾静脉血栓2例;肠系膜上动脉栓塞2例;动脉瘤破裂1例;血管周围炎1例。结论 急诊CTA及CTV可以确诊血管源性的急腹症,对临床治疗不缓解、症状与体征不符的患者要及时行CTA或CTV检查排除血管源性急腹症,以减少误诊率。
中文关键词:CT血管造影  急腹症  体层摄影术  X线计算机
 
Clinical Value of CT Angiography in the Diagnosis of Acute Abdomen
Abstract:Objective To explore the clinical value of CT angiography in the diagnosis of acute abdomen. Methods We studyied clinical data on misdiagnosis of 16 patients with CT angiography. Results The misdiagnosis rate of acute abdomen caused by vascular lesions was 43.2%(16/37). Six cases were with aortic dissection, of which 3 cases involving superior mesenteric artery dissection and 2 cases involving the celiac trunk. 1 case were with superior mesenteric artery dissection, 2 cases were with aortic intramural hematoma, and 3 cases were with superior mesenteric vein thrombosis,of which 2 cases with portal vein and splenic vein thrombosis. 2 cases were with superior mesenteric artery thrombosis. 1 cast was abdominal aortic aneurysm hemorrhage,1 case were with periaortitis. Conclusion The definite diagnosis of acute abdomen caused by vascular lesions can be made through CTA or CTV, when unrelievable abdominal pain and the symptoms are not in accordance with the abdomen sign, to reduce misdiagnosis. CTA or CTV can become the preferred emergency method of examination.
keywords:CT angiography  Acute abdomen  Tomography  X-ray computed
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