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双语推荐：绞窄性肠梗阻

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评价64层螺旋CT图像后处理技术对绞窄性肠梗阻的诊断效果,为临床提供科学参考。方法:采用回顾性分析方法对30例绞窄性肠梗阻患者的全腹CT平扫和增强扫描及图像后处理资料进行分析。结果:常规轴位图像和常规轴位图像联合后处理图像提示肠梗阻准确率均100%,差异无统计学意义(P0.05)。常规轴位图像提示绞窄性肠梗阻准确率73.33%,肠梗阻部位准确率76.67%、肠梗阻病因准确率73.33%,常规轴位图像联合后处理图像显示绞窄性肠梗阻准确率96.67%,肠梗阻部位准确率96.67%,肠梗阻病因准确率96.67%,两者差异均有统计学意义(均P0.05)。结论:常规轴位图像联合后处理图像在绞窄性肠梗阻的诊断效果显著,值得临床推广使用。
Objective:To evaluate the diagnosis effect of 64 slice spiral CT image post-processing techniques in strangulated intestinal obstruction,to provide scientific reference for clinical.Methods:Using retrospective analysis methods to analyze the abdominal computed tomography(CT)scan and enhanced scanning and image post-processing data of 30 cases of patients with strangulated intestinal obstruction.Results:Conventional axial images and conventional shaft joint image post-processing images showed that the accuracy rate of intestinal obstruction were all 100%,with no significant difference(P>0.05).Conventional axial images showed that the accuracy rate of strangulated intestinal obstruction was 73.33%,the accuracy rate of intestinal obstruction position was 76.67% ,the accuracy rate of intestinal obstruction etiology was 73.33% ,conventional shaft joint image post-processing images showed that the accuracy rate of strangulated intestinal obstruction was 96.67% ,the accuracy rate of intestina

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目的：探讨血清肌酸激酶、C-反应蛋白和D-二聚体水平的测定在绞窄性肠梗阻早期诊断中的应用价值,以期为绞窄性肠梗阻的早期诊断提供依据。方法①在手术治疗前2h采集血液标本测定48例单纯性肠梗阻（单纯性肠梗阻组）和36例绞窄性肠梗阻（绞窄性肠梗阻组）患者的血清肌酸激酶、C-反应蛋白和D-二聚体水平,对照50例健康成年（正常对照组）的血清肌酸激酶、C-反应蛋白和D-二聚体水平。②比较在绞窄性肠梗阻组中15例未发生肠坏死者与48例（单纯性肠梗阻组）血清肌酸激酶、C-反应蛋白和D-二聚体水平。同时比较在绞窄性肠梗阻组中经手术证实的21例肠坏死者与15例未发生肠坏死者的血清肌酸激酶、C-反应蛋白和D-二聚体水平。应用相关性分析研究绞窄性肠梗阻患者的血清肌酸激酶、C-反应蛋白和D-二聚体三个指标之间的相关性。结果①单纯性肠梗阻组的血清肌酸激酶、C-反应蛋白和D-二聚体水平较正常对照组均无明显升高（P〉0.05）。绞窄性肠梗阻组的血清肌酸激酶、C-反应蛋白和D-二聚体水平均较正常对照组及单纯性肠梗阻组明显升高（P〈0.001）。②在绞窄性肠梗阻组中无肠坏死者血清肌酸激酶、C-反应蛋白和D-二聚体水平均高于（单纯性肠梗阻组）（分别为P〈0.05, P〈0.001, P〈0.001
Objective To investigate the application value of serum creatine kinase, C-reactive protein and D-dimer detection in early diagnosis of strangulated intestinal obstruction, in order to provide reference for early diagnosis of strangulated intestinal obstruction. Methods ①The levels of serum creatine kinase, C-reactive protein and D-dimer were detected in 2 h before surgery by blood preparation of 48 simple intestinal obstruction patients (simple intestinal obstruction group) and 36 strangulated intestinal obstruction patients (strangulated intestinal obstruction group). These were compared with the levels of serum creatine kinase, C-reactive protein and D-dimer of 50 healthy adults (normal control group). ②The levels of serum creatine kinase, C-reactive protein and D-dimer were compared between 15 strangulated intestinal obstruction cases without intestinal necrosis in the strangulated intestinal obstruction group and 48 cases in the simple intestinal obstruction group. The

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探讨微生态制剂对绞窄性肠梗阻肠道菌群失调的治疗作用。方法:绞窄性肠梗阻208例,按入院先后(3:1)分为两组:治疗组(156例)为常规治疗+术中及术后用微生态制剂;对照组(52例)为常规治疗而不用微生态制剂。以腹腔内渗液内毒素、D-乳酸水平反映肠通道性变化。术中两组绞窄段、绞窄前段及后段肠内容物作细菌培养。结果:绞窄性肠梗阻患者存在明显的肠道菌群失调;微生态制剂治疗,可迅速使肠道主要优势菌群(双歧杆菌和乳酸杆菌)增殖,病原菌(大肠杆菌和肠球菌)被抑制;且肠通道性较早康复。结论:微生态制剂可尽快使绞窄性肠梗阻肠道菌群失调恢复正常,肠通道性较早康复。
To evaluate the influence of microecological peparations on intestinal flora imbalance in diseases of strangulated intestinal obstruction.Methods:208 patients suffering from strangulated intestinal obstruction were divided into test group(n=156,treated by microecological preparations ) and control group(n=52).D-lactate,endotoxin in abdominal fluid were detected in all the patients.The effects of microecological preparations on intestinal flora imbalance were invested.Results:There is intestinal flora imbalance in diseases of strangulated intestinal obstruction.concentration of D-lactate and endotoxin in test group declined to normal range at 3d after operation,while in control group reduced to normal range at 5d after operation.At 3、5 days,the Bi fidobecterium and Lactobacillus in the test group were much higher than those of the control group;While the Enterobacterium and Enterococcus in the test group were much lower than those of the control group.The intestinal flora imb

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目的：探讨16排CT和腹部X线平片在肠梗阻诊断中的临床价值。方法：回顾性分析我院收治的86例肠梗阻患者的临床资料，均分别使用16排CT和腹部X线平片进行诊断，以手术病理结果为金标准，比较两种检查诊断符合率的差异。结果：在确定肠梗阻有无、发病原因、发生部位和绞窄性梗阻等方面，16排CT诊断符合率均显著高于腹部X线平片（P＜0．05）。结论：在诊断肠梗阻中，16排CT敏感，对诊断肠梗阻部位、病因和有否绞窄等方面较腹部X线平片检查优势明显。
Objective:To investigate the value of 16-slice CT,and abdominal X-ray in the diagnosis of intestinal obstruction.Methods:A retrospective analysis of 86 cases in our hospital clinical data of patients with intestinal obstruction.comparing two checks diagnosis rate dif erences by surgery pathology results as the gold standard.Results:in determi-ning whether intestinal obstruction,etiology,location and other aspects of strangulation obstruction.16-slice CT diagnosis was significantly higher than abdominal X-ray film (P<0.05).Conclusions:in the diagnosis of intestinal obstruction,a 16-slice CT sensitive parts in the diagnosis of intestinal obstruction,causes and whether other aspects of strangulation than abdominal X-ray examination obvious advantages.

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探讨多层螺旋CT(muhislicse computed tomography,MSCT)在肠梗阻诊断中的应用价值。方法:对48例经128层MSCT检查诊断为肠梗阻的病例进行回顾性分析。结果:48例患者MSCT诊断结果均与术后病理结果或临床随访结果相符合,48例肠梗阻中,粘连21例,肿瘤6例,肠套叠5例,嵌顿疝4例,先天性巨结肠1例,麻痹性3例,粪石2例,肠扭转6例,CT对急性肠梗阻病因诊断符合率为91.66%(44/48)。结论:128层MSCT检查能显著提高肠梗阻存在与否、对梗阻病因、有无绞窄诊断准确率高,对诊断急性肠梗阻有很高的价值。
Objective:To discuss the diagnostic value of intestinal obstruction with MSCT scanning.Method:48 cases of bowel obstruction diagnosed by 128 slice MSCT were retrospectively analyzed and discussed.Result:MSCT diagnosis of 48 cases was consistent with the results of surgical finds or clinical follow-up.48 cases of intestinal obstruction included 21 cases of adhesion,6 cases of neoplasm,5 cases of intussusceptions,4 cases of incarcerated hernia,1 case of hirschsprung’s disease,3 cases of paralysis,2 cases of bezoars,6 cases of volvulus.The coincidence rate of MSCT diagnosis was 91.66%(44/48).Conclusion:MSCT can correctly diagnose the presence of the illness,as well as its causes and strangulation .MSCT has a high value in the evaluation of acute intestinal obstruction.

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目的 探讨术后早期炎性肠梗阻的病因、临床表现、诊断及治疗.方法 回顾性分析50例术后早期炎性肠梗阻患者的临床资料.结果 44例行保守治疗治愈,平均治愈时间10.3 d；手术治疗6例,其中4例行肠粘连松解术,2例行大部分小肠切除术.术后出现切口感染2例,术后并发长期腹泻及营养不良2例.结论 术后早期肠梗阻多发生于术后1～2周,与手术操作广泛,手术创伤大有关.典型症状为肠梗阻表现,治疗首选保守疗法,如保守治疗无效或有肠绞窄可能时应手术治疗,手术方式应力求简单有效.
Objective To discuss the etiological factor,clinical situation,diagnosis and therapy of early postoperative inflammatory small bowel obstruction.Methods The clinical data of fifty cases with early postoperative inflammatory small bowel obstruction were analyzed retrospectively.Results 44 cases were cured in a mean period of 10.3 days with non-operative therapy.Six cases received operation including 4 cases enterolysis and 2 cases section intestinal resection.Infection of incisional wound occurred in 2 case and long time diarrhoea and malnutrition occurred in 2 case.Conclusion Early postoperative inflammatory small bowel obstruction mainly occurs in about 1-2 weeks after operation and is related to extensive operation and insult.Early postoperative inflammatory small bowel obstruction has typical signs and symptoms of bowel obstrurtion.If conservative therapy isnt effective or strangulation of bowel occurs,operation should be adopted and operation style should be simple and effective.

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目的探讨螺旋CT用于肿瘤性肠梗阻诊断的应用价值。方法回顾性分析我院2012年10月，2013年6月经手术证实为肿瘤性肠梗阻且术前均行腹部x线平片和CT扫描两种检查的32例患者的临床资料，对两种检查方法的检查结果进行比较分析。结果（1）两种诊断方式在梗阻诊断率、梗阻病因诊断率、梗阻部位诊断率以及绞窄的诊断率上比较有明显差异（P〈0．05）；（2）CT诊断结果与术后病理TNM分期结果比较无显著性差异（P〈0．05）。结论螺旋CT用于诊断肿瘤性肠梗阻效果显著，且能够有效提高梗阻诊断率，明显优于腹部x线平片检查。
Objective To investigate the application of spiral CT in the diagnosis of neoplastic obstruction. Methods The files of abdominal plain film radiography and CT examination of 32 neoplastic obstruction patients with surgery from October 2012 to June 2013 were retrospectively reviewed,the diagnostic results of twos diagnostic methods were analyzed and compared. Results (1)There were significant differences about accurate diagnosis rates of ileus, accurate diagnosis rates of the ileus cause,accurate diagnosis rates of ileus location,accurate diagnosis rates of strangulated ileus between two diagnostic methods(P 0.05). Conclusion Spiral CT has a good effect on diagnosing neoplastic obstruction,and it can improve the diagnostic accuracy.

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目的探讨NO在改良复方大承气汤治疗粘连性肠梗阻时的变化规律及可能机制。方法将40例良性病变性粘连性肠梗阻作为研究对象及10例非肠梗阻病人作为服药前对照,检测服药前后肠梗阻症状和体征与外周血中NO变化,同时观察传统中医诊察手段之一的舌象变化与NO变化之间的关系。结果术前肠梗阻与非肠梗阻患者外周血中NO值有明显的差别(P0.05);服用中药后缓解组与未缓解组除了有临床症状变化差别外,血中NO值前者逐渐下降而后者仍持续高位(P0.05);缓解组服药后先有肠鸣音的增强、但病理音减少、NO值也随着下降,而未缓解组肠鸣音和病理音同时增强,不伴有NO值的下降(P0.05),缓解组与未缓解组舌象变化值也与NO值的高低相平行。结论外周血中NO值能反映肠梗阻的严重程度,服通里攻下药物后NO值仍保持在高位提示为完全性肠梗阻,有肠缺血、肠绞窄倾向,为是否中转手术提供参考。NO值也能反映梗阻以上肠段的多少,即高位或低位梗阻。
Objective To investigate the NO variation rule and possible mechanism during the treatment of adhesive intestine obstruction with modified Dachengqi decoction. Methods Forty cases of benign adhesive intestine obstruction patients and ten cases non-intestine obstruction as control group were admitted. The symptoms,borborygmus and NO variation in peripheral circu-lation were observed. The relation of tongue picture change s,which was one of the important diagnosis method of the traditional chinese medicine,with NO was also been investigated. Results The value of NO in peripheral blood before operation have signifi-cant difference between obstruction and no-obstruction patients(P<0.05). Besides the difference of clinical symptoms between the relieve group and no-relieve group after taking modified Dachengqi decoction,the NO value in relieve group gradually decreased, but in no-relieve group kept in higher altitude (P<0.05). The borborygmus first enhanced after taking modified Da

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比较超声和腹部X线平片对于诊断儿童急性肠梗阻的实用价值进行分析,以便根据临床实际情况选择合适的检查方法。方法:选取收入我院的120例患有急性肠梗阻的儿童,均在进行手术前行超声检查和腹部X线平片检查,对手术结果进行分析,讨论这两种检查方法对于临床疾病的诊断准确性。结果:超声的确诊率为97%,腹部X线平片的确诊率为85%,腹部X线平片检查明显低于超声检查,对两种方法进行比较,具有统计学的意义(P0.01),超声对于儿童急性肠梗阻的确诊率明显高于腹部X线平片的确诊率。结论:传统腹部平片诊断儿童急性肠梗阻的敏感性和特异性较低,而超声确诊儿童急性肠梗阻的正确率接近于100%,与X线等其他检查相比超声对于梗阻的原因诊断准确性也极高,是否发生绞窄性肠梗阻超声检查比X线平片显示更有价值。
Objective:To compare the practical value of ultrasound and abdominal X-ray plain film in the diagnosis of acute intestinal obstruction in children so as to provide sufficient evidences for appropriate selection of diagnostic method during clinical practice. Methods:120 children with acute intestinal obstruction admitted in our hospital were enrolled in this study. They all were diagnosed with ultrasound and abdominal X-ray plain film before taking surgery and the results were analyzed to compare their diagnostic accuracy. Results:The correct diagnosis rate for ultrasound(97%) was obviously higher than abdominal X-ray plain film(85%)and results comparison gave a significant difference(P<0.01). Ultrasound had a higher diagnosis rate than abdominal X-ray plain film in the diagnosis of acute intestinal obstruction in children. Conclusions:Traditional abdominal X-ray plain film has poor sensitivity and specificity in the diagnosis of acute intestinal obstruction in children while ultrasound

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探讨DR与CT两种检查手段对肠梗阻的诊断价值。方法:收集我院确诊为肠梗阻的86例患者治疗前腹部DR平片及CT两种检查的相关资料进行回顾性分析。结果:经CT检查明确存在梗阻者82例(96.4%),明确梗阻部位者73例(86.9%);经DR检查的患者中,明确存在梗阻和梗阻部位的比例与CT检查结果大体相当,差异没有统计学意义(P0.05)。CT检查明确梗阻原因和梗阻类型者比例明显高于DR检查的患者,两组比较差异有统计学意义(P0.05)。结论:DR在肠梗阻诊断的准确性方面与CT相当,但是明确梗阻原因、是否伴有绞窄等方面CT的优势更为明显。
Objective :To study the diagnosis value of CT and DR two kind of examination methods for intestinal ob-struction .Methods :The DR and CT related data of 86 cases of intestinal obstruction diagnosed in the hospital before treatment were collected and retrospectively analyzed .Results :By CT examination ,82 cases (96 .4% ) were identified obstruction ,73 cases were identified the site of obstruction (86 .9% ) ;which results were roughly same with the DR examinations ,and the difference between two methods was not statistically significant (P> 0 .05) .However ,CT exam-ination showed obvious advantages in the aspects of identifying obstruction causes and obstruction type than that of DR ,and the differences were significant (P< 0 .05) .Conclusion :The accuracy of DR in the diagnosis of intestinal ob-struction was same as CT ,but CT was superior to DR in the aspects of identifying obstruction causes and whether ob-struction with strangulation .

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