中华普通外科杂志
中華普通外科雜誌
중화보통외과잡지
CHINESE JOURNAL OF GENERAL SURGERY
2014年
12期
923-926
,共4页
吕和平%倪海真%沈传利%黄景勇%潘乐门%苏翔%黄崇青%虞冠锋
呂和平%倪海真%瀋傳利%黃景勇%潘樂門%囌翔%黃崇青%虞冠鋒
려화평%예해진%침전리%황경용%반악문%소상%황숭청%우관봉
静脉血栓形成%纤维蛋白原%肠系膜静脉%D二聚体
靜脈血栓形成%纖維蛋白原%腸繫膜靜脈%D二聚體
정맥혈전형성%섬유단백원%장계막정맥%D이취체
Venous thrombosis%Fibrinogen%Mesenteric Veins%D-dimer
目的 探讨急诊血液化验及肠壁厚度测量对肠系膜上静脉血栓致肠坏死的早期诊断价值.方法 回顾性分析2006年4月至2013年6月19例肠系膜上静脉血栓患者的临床资料,分为肠坏死组10例,肠淤血组9例.比较2组白细胞总数、中性粒细胞比例、红细胞计数、血小板计数、肌酸激酶(creatine kinase,CK)、肌酸激酶同工酶(MB isoenzyme of creatine kinase,CK-MB)、国际标准化比值(international normalized ratio,INR)、纤维蛋白原及D二聚体,测量2组CT横断面肠壁最厚处的厚度.结果 肠坏死组血浆D二聚体(3.27 ～ 20.00) μg/ml,中位值(19.85) μg/ml,肠淤血组血浆D二聚体(0.49～ 13.90) μg/ml,中位值(5.55) μg/ml,两者比较差异有统计学意义(P＜0.05).以D二聚体＞ 10 μg/ml为截点,对诊断肠系膜上静脉血栓致肠坏死的灵敏度、特异度、阳性预测值及阴性预测值分别为:70％,89％,87.5％,73％.肠坏死组肠壁厚度为(8.35～15.45) mm,中位值(10.48) mm,肠淤血组肠壁厚度为(1.29～8.70) mm,中位值(1.43) mm,两者比较差异有统计学意义(P＜0.05).以小肠壁厚度＞8 mm为截点,对诊断肠系膜上静脉血栓致肠坏死的灵敏度、特异度、阳性预测值及阴性预测值分别为:100％,89％,90.9％,100％.结论 D二聚体浓度及肠壁厚度对肠系膜上静脉血栓致肠坏死具有重要预测价值.
目的 探討急診血液化驗及腸壁厚度測量對腸繫膜上靜脈血栓緻腸壞死的早期診斷價值.方法 迴顧性分析2006年4月至2013年6月19例腸繫膜上靜脈血栓患者的臨床資料,分為腸壞死組10例,腸淤血組9例.比較2組白細胞總數、中性粒細胞比例、紅細胞計數、血小闆計數、肌痠激酶(creatine kinase,CK)、肌痠激酶同工酶(MB isoenzyme of creatine kinase,CK-MB)、國際標準化比值(international normalized ratio,INR)、纖維蛋白原及D二聚體,測量2組CT橫斷麵腸壁最厚處的厚度.結果 腸壞死組血漿D二聚體(3.27 ～ 20.00) μg/ml,中位值(19.85) μg/ml,腸淤血組血漿D二聚體(0.49～ 13.90) μg/ml,中位值(5.55) μg/ml,兩者比較差異有統計學意義(P＜0.05).以D二聚體＞ 10 μg/ml為截點,對診斷腸繫膜上靜脈血栓緻腸壞死的靈敏度、特異度、暘性預測值及陰性預測值分彆為:70％,89％,87.5％,73％.腸壞死組腸壁厚度為(8.35～15.45) mm,中位值(10.48) mm,腸淤血組腸壁厚度為(1.29～8.70) mm,中位值(1.43) mm,兩者比較差異有統計學意義(P＜0.05).以小腸壁厚度＞8 mm為截點,對診斷腸繫膜上靜脈血栓緻腸壞死的靈敏度、特異度、暘性預測值及陰性預測值分彆為:100％,89％,90.9％,100％.結論 D二聚體濃度及腸壁厚度對腸繫膜上靜脈血栓緻腸壞死具有重要預測價值.
목적 탐토급진혈액화험급장벽후도측량대장계막상정맥혈전치장배사적조기진단개치.방법 회고성분석2006년4월지2013년6월19례장계막상정맥혈전환자적림상자료,분위장배사조10례,장어혈조9례.비교2조백세포총수、중성립세포비례、홍세포계수、혈소판계수、기산격매(creatine kinase,CK)、기산격매동공매(MB isoenzyme of creatine kinase,CK-MB)、국제표준화비치(international normalized ratio,INR)、섬유단백원급D이취체,측량2조CT횡단면장벽최후처적후도.결과 장배사조혈장D이취체(3.27 ～ 20.00) μg/ml,중위치(19.85) μg/ml,장어혈조혈장D이취체(0.49～ 13.90) μg/ml,중위치(5.55) μg/ml,량자비교차이유통계학의의(P＜0.05).이D이취체＞ 10 μg/ml위절점,대진단장계막상정맥혈전치장배사적령민도、특이도、양성예측치급음성예측치분별위:70％,89％,87.5％,73％.장배사조장벽후도위(8.35～15.45) mm,중위치(10.48) mm,장어혈조장벽후도위(1.29～8.70) mm,중위치(1.43) mm,량자비교차이유통계학의의(P＜0.05).이소장벽후도＞8 mm위절점,대진단장계막상정맥혈전치장배사적령민도、특이도、양성예측치급음성예측치분별위:100％,89％,90.9％,100％.결론 D이취체농도급장벽후도대장계막상정맥혈전치장배사구유중요예측개치.
Objective To evaluate emergency blood test and bowel wall thickness measurement in predicting intestinal infarction caused by acute superior mesenteric vein thrombosis (SMV).Methods 19 SMV patients were divided into two groups:necrotic bowel group (NB,n =10) and congested bowel group (CB,n =9).White blood cell,neutrophil ratio,red blood cell,platelet,creatine kinase (CK),MB isoenzyme of creatine kinase (CK-MB),international normalized ratio (INR),fibrinogen and D-dimer were compared between the two groups.The bowel wall thickness measured by CT scan were compared between the two groups.Results The levels of D-dimer in NB and CB were 19.85 (3.27-20.00) μg/ml,5.55(0.49-13.90) μg/ml,respectively (P ＜ 0.05).Sensitivity,specificity,positive predictive value,negative predictive value of the D-dimer ＞ 10 μg/mnl in diagnosing intestinal infarction were 70％,89％,87.5％,73％.The bowel wall thickness in NB and CB were 10.48 (8.35-15.45) mm,1.43 (1.29-8.70) mm,respectively (P ＜ 0.05).Sensitivity,specificity,positive predictive value,negative predictive value of the bowel wall thickness ＞ 8 mm in diagnosing intestinal infarction were 100％,89％,90.9％,100％.Conclusions D-dimer and bowel wall thickness were able to predict for intestinal infarction caused by SMV.
