安徽医学
安徽醫學
안휘의학
ANHUI MEDICAL JOURNAL
2014年
9期
1255-1257,1258
,共4页
回盲部病变%B超%CT%X线钡剂灌肠造影%结肠镜检查
迴盲部病變%B超%CT%X線鋇劑灌腸造影%結腸鏡檢查
회맹부병변%B초%CT%X선패제관장조영%결장경검사
Ileocecal lesions%B-ultrasound%CT%Barium enema radiography%Colonoscopy
目的：分析回盲部病变的病因及临床特征，提高对回盲部病变认识及诊治水平。方法收集我院自2005年5月至2014年3月有完整资料的回盲部疾病的手术病例，统计入院后的B超、CT、X线钡剂灌肠造影及结肠镜等检查结果及术前诊断和术后病理诊断。结果资料完整的回盲部病变患者55例，临床表现为腹痛、腹胀48例，以右下腹及脐周为主，右下腹扪及包块16例，便血或脓血便9例，腰痛2例，腹泻4例，肠梗阻7例，肠套叠2例，肠穿孔2例。术前初诊胆囊结石1例，8例术前初诊急性阑尾炎，术中探查发现回盲部包块（其中回盲部癌2例，回盲部间质瘤1例，回盲部憩室伴脓肿1例，回盲部炎性肿块4例），阑尾炎手术后3例（回盲部癌1例，回盲部炎性肿块1例，回盲部肠管皮肤瘘1例）。结肠镜检查与B超、CT及X线钡剂灌肠造影等检查相比，对提高术前诊断价值更大。结论详细询问病史与体格检查，配合结肠镜等辅助检查综合判断，可以有效提高临床对回盲部病变的诊断水平。
目的：分析迴盲部病變的病因及臨床特徵，提高對迴盲部病變認識及診治水平。方法收集我院自2005年5月至2014年3月有完整資料的迴盲部疾病的手術病例，統計入院後的B超、CT、X線鋇劑灌腸造影及結腸鏡等檢查結果及術前診斷和術後病理診斷。結果資料完整的迴盲部病變患者55例，臨床錶現為腹痛、腹脹48例，以右下腹及臍週為主，右下腹捫及包塊16例，便血或膿血便9例，腰痛2例，腹瀉4例，腸梗阻7例，腸套疊2例，腸穿孔2例。術前初診膽囊結石1例，8例術前初診急性闌尾炎，術中探查髮現迴盲部包塊（其中迴盲部癌2例，迴盲部間質瘤1例，迴盲部憩室伴膿腫1例，迴盲部炎性腫塊4例），闌尾炎手術後3例（迴盲部癌1例，迴盲部炎性腫塊1例，迴盲部腸管皮膚瘺1例）。結腸鏡檢查與B超、CT及X線鋇劑灌腸造影等檢查相比，對提高術前診斷價值更大。結論詳細詢問病史與體格檢查，配閤結腸鏡等輔助檢查綜閤判斷，可以有效提高臨床對迴盲部病變的診斷水平。
목적：분석회맹부병변적병인급림상특정，제고대회맹부병변인식급진치수평。방법수집아원자2005년5월지2014년3월유완정자료적회맹부질병적수술병례，통계입원후적B초、CT、X선패제관장조영급결장경등검사결과급술전진단화술후병리진단。결과자료완정적회맹부병변환자55례，림상표현위복통、복창48례，이우하복급제주위주，우하복문급포괴16례，편혈혹농혈편9례，요통2례，복사4례，장경조7례，장투첩2례，장천공2례。술전초진담낭결석1례，8례술전초진급성란미염，술중탐사발현회맹부포괴（기중회맹부암2례，회맹부간질류1례，회맹부게실반농종1례，회맹부염성종괴4례），란미염수술후3례（회맹부암1례，회맹부염성종괴1례，회맹부장관피부루1례）。결장경검사여B초、CT급X선패제관장조영등검사상비，대제고술전진단개치경대。결론상세순문병사여체격검사，배합결장경등보조검사종합판단，가이유효제고림상대회맹부병변적진단수평。
Objective To analyze the etiology and clinical data of ileocecal lesions to improve the level of the diagnosis and treat -ment.Methods Clinical data of all patients with ileocecal lesions were analyzed in our department from May 2005 to April 2014.All cases had received the routine inspection ,B-ultrasound examination ,CT,barium enema radiography and colonoscopy ,and were confirmed by histopa-thology after the operation.Results The clinical symptoms of all patients included abdominal pain or distension (48 cases),right lower ab-dominal mass (16 cases),hematochezia and blood purulent stool (9 cases),low back pain (2 cases),diarrhea (4 cases),intestinal obstruc-tion (7 cases),intussusception (2 cases) and intestinal perforation (2 cases).In all patients,one case was misdiagnosed as cholecystolithia-sis before operation;eight cases were misdiagnosed as acute appendicitis but were found in the operation that there was ileocecal mass inclu -ding malignancies in ileocecal region ,stromal tumor,diverticulitis and inflammatory mass .Three cases with the history of appendectomy were diagnosed as malignancies in ileocecal region ,inflammatory mass and enterocutaneous fistula respectively .Colonoscopy was a better method to improve the correct rate of the diagnosis of ileocecal lesions than B-ultrasound examination ,CT and barium enema radiography .Conclusion Detailed disease history and attentive physical examination combined with colonoscopy ,B-ultrasound,CT,barium enema radiography can effec-tively improve the understanding and clinical diagnosis of ileocecal lesions .
