河北医学2018，Vol.24Issue(6)：961-966,6.DOI:10.3969/j.issn.1006-6233.2018.06.021
急腹症患者的超声表现及误诊原因分析
Ultrasonographic Findings and causes of Misdiagnosis for Patients with Acute Abdomen Diseases
摘要
Abstract
Objective: To analyze the ultrasonic findings of acute abdominal diseases and the causes of misdiagnosis. Methods: 100 cases of patients with acute abdominal diseases treated in our hospital from April 2012 to May 2017 were selected and examined with color Doppler ultrasonography. According to the features of ultrasonic images, the types of acute abdominal diseases were diagnosed, and the results were compared with the diagnosis results of operation and pathology. The accuracy and misdiagnosis rate of ultrasonic diagnosis of acute abdominal diseases, and the causes of misdiagnosis were analyzed. Results: According to the sites, size, echo and blood flow images of lesions displayed by ultrasound, it was found that the ultrasonic findings of patients with acute abdominal diseases caused by different causes were obvious. The postoperative pathological diagnosis of 100 patients with acute abdominal diseases showed 19 cases of urinary calculi, 18 cases of hepatic stones and gallstones, 15 cases of acute appendicitis, 11 cases of acute cholecystitis, 10 cases of acute pan-creatitis, 10 cases of intestinal obstruction, 12 cases of intestinal perforation, 5 cases of ectopic pregnancy and ovarian torsion, and 1 case of abdominal large vascular disease. The accuracy rate of ultrasonic diagnosis was 84.00%, and the misdiagnosis rate was 16.00%. Among the misdiagnosed patients, there were 2 cases of uri-nary calculi misdiagnosed as chronic colitis and intestinal obstruction, 1 case of gallstone misdiagnosed as in-testinal polyps, 1 case of acute appendicitis misdiagnosed as urinary calculi, 2 cases of acute cholecystitis mis-diagnosed as gallstones and cholestasis, 1 case of acute pancreatitis misdiagnosed as intestinal fistula, 1 case of intestinal obstruction and 1 case of intestinal perforation misdiagnosed as acute appendicitis, 2 cases of ec-topic pregnancy misdiagnosed as purulent appendicitis and early pregnancy, 3 cases of ovarian torsion misdiag-nosed as purulent appendicitis, appendix perforation and early pregnancy, and 1 case of abdominal large vas-cular disease misdiagnosed as ectopic pregnancy. The causes of misdiagnosis mainly includes poor ultrasonic findings, non obvious signs, atypical ultrasonic features or similar diseases. Conclusion: The accuracy rate of Doppler ultrasound is high in the diagnosis of acute abdominal diseases. However, poor ultrasonic findings, non obvious signs and atypical ultrasonic features may cause misdiagnosis. Other ways can be used for differen-tial diagnosis.关键词
急腹症/多普勒超声/误诊/鉴别诊断Key words
Acute abdominal diseases/Doppler ultrasound/Misdiagnosis/Differential diagno-sis引用本文复制引用
王丽,汪旭..急腹症患者的超声表现及误诊原因分析[J].河北医学,2018,24(6):961-966,6.基金项目
湖北省自然科学基金项目,(编号:2013BD0145) （编号:2013BD0145）
