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中华疝和腹壁外科杂志(电子版) ›› 2021, Vol. 15 ›› Issue (01) : 40 -43. doi: 10.3877/cma.j.issn.1674-392X.2021.01.010

所属专题: 文献

临床论著

彩色多普勒超声在腹外疝鉴别诊断中的研究
高燕1,(), 金琳1   
  1. 1. 241001 安徽芜湖,皖南医学院第二附属医院超声科
  • 收稿日期:2020-09-09 出版日期:2021-02-18
  • 通信作者: 高燕
  • 基金资助:
    安徽省自然科学基金(1408085MH152)

Sensitivity and specificity of color Doppler ultrasound in the differential diagnosis of external abdominal external hernia

Yan Gao1,(), Lin Jin1   

  1. 1. Department of Ultrasound, the Second Affiliated Hospital of Wannan Medical College, Wuhu 241001, China
  • Received:2020-09-09 Published:2021-02-18
  • Corresponding author: Yan Gao
引用本文:

高燕, 金琳. 彩色多普勒超声在腹外疝鉴别诊断中的研究[J/OL]. 中华疝和腹壁外科杂志(电子版), 2021, 15(01): 40-43.

Yan Gao, Lin Jin. Sensitivity and specificity of color Doppler ultrasound in the differential diagnosis of external abdominal external hernia[J/OL]. Chinese Journal of Hernia and Abdominal Wall Surgery(Electronic Edition), 2021, 15(01): 40-43.

目的

探讨腹外疝鉴别诊断中彩色多普勒超声的应用效果,初步分析诊断的敏感性与特异性。

方法

回顾性分析2017年1月至2019年8月皖南医学院第二附属医院超声科接诊的77例拟诊断为腹外疝患者的信息。全部患者均接受彩色多普勒超声检查、手术探查,分析彩色多普勒超声对腹外疝的诊断价值。

结果

77例患者中,男性65例,女性12例,平均年龄(61.66±13.81)岁,平均病程(3.02±0.86)个月。经过手术探查,共有74例确诊为腹外疝,其中斜疝67例,直疝5例,股疝1例,半月线疝1例。利用彩色多普勒超声共诊断出病灶107个,2例腹股沟斜疝出现误诊,误诊为脂肪瘤和淋巴结肿大,发生1例漏诊。彩色多普勒超声对腹外疝的诊断敏感度为96.10%,诊断特异度为100%,诊断准确度为97.29%,阳性预测值为95.94%,阴性预测值为100%,彩色多普勒超声与手术两种诊断方法的Kappa值为0.736。

结论

彩色多普勒超声在腹外疝的鉴别诊断中,具有良好的准确性,实际工作中需结合影像学结果、临床表现等综合考虑,为术前诊断提供良好的参考依据。

Objective

To explore the application effect of color Doppler ultrasound in the differential diagnosis of abdominal external hernia, and to analyze the sensitivity and specificity of diagnosis.

Methods

A retrospective analysis of the information of 107 patients who were to be diagnosed as abdominal external hernias admitted to the ultrasound department of the Second Affiliated Hospital of Wannan Medical College from January 2017 to August 2019. All patients underwent color Doppler ultrasound examination and operation, to analysis of the value of color Doppler ultrasound in the diagnosis of abdominal external hernia.

Results

Among the patients, 99 were males and 8 were females, with an average age of (61.40±13.81) years and an average course of (3.02±0.86) months. After surgical exploration, a total of 101 cases were diagnosed as abdominal external hernias, including 67 cases of indirect inguinal hernia, 30 cases of direct hernia, 3 cases of femoral hernia, and 1 case of spigelian hernia. A total of 107 lesions were diagnosed by color Doppler ultrasound. 2 cases of inguinal hernia were misdiagnosed as lipoma and lymphadenopathy, and 1 case was missed. The diagnostic sensitivity of color Doppler ultrasound for abdominal external hernia is 94.39%, the diagnostic specificity is 83.33%, the diagnostic accuracy is 97.03%, the positive predictive value is 99.01%, and the negative predictive value is 85.71%. The Kappa value of the two diagnostic methods between color Doppler ultrasound and surgery is 0.736.

Conclusion

Color Doppler ultrasound has good accuracy in the differential diagnosis of abdominal external hernia. In practical work, comprehensive considerations such as imaging results and clinical manifestations should be combined to provide a good reference for preoperative diagnosis.

表1 腹外疝的手术诊断以及彩色多普勒超声诊断结果
图1 彩色多普勒超声所示为疝的内容物
图2 彩色多普勒超声所示为疝囊
表2 彩色多普勒超声与手术对腹外疝的诊断结果分析(例)
[1]
王建平. 腹腔镜下腹股沟疝修补术治疗腹股沟疝患者的疗效及安全性分析[J]. 中国药物与临床, 2020, 20(8): 1342-1344.
[2]
林栓琴,赵亚笙. 腹股沟疝患者无张力疝修补术后术区感染的相关因素探析[J]. 山西医药杂志, 2020, 49(14): 1854-1856.
[3]
Miyaki A, Yamaguchi K, Kishibe S, et al. Diagnosis of inguinal hernia by prone-vs. supine-position computed tomography[J]. Hernia, 2017, 21(5): 705-713.
[4]
Miller HJ. Inguinal hernia: mastering the anatomy[J]. Surg Clin North Am, 2018, 98(3): 607-621.
[5]
吴昊,徐茂奇,方寅, 等. 嵌顿性腹股沟疝急诊手术术后复发影响因素的Cox回归分析[J]. 皖南医学院学报, 2020, 39(4): 362-364, 375.
[6]
马颂章. 疝外科学[M]. 5版. 北京: 人民卫生出版社, 2002: 222.
[7]
王晨光,徐臣炎,谢昊玮, 等. 腹股沟嵌顿疝无张力修补疗效观察[J]. 腹部外科, 2017, 30(6): 475-478.
[8]
方彦鹏,岳馨,张礼宪, 等. 彩色多普勒超声在腹外疝鉴别诊断中的应用[J]. 中国民族民间医药, 2010, 19(19): 110-111.
[9]
张志,刘威,王刚, 等. 急诊腹腔镜技术在成年人腹股沟嵌顿疝治疗中的应用策略[J]. 腹腔镜外科杂志, 2020, 25(7): 505-508.
[10]
杨耀鑫,邱钧. 腹股沟疝病人术后并发症发生危险因素的探讨[J]. 安徽医药, 2020, 24(6): 1159-1162.
[11]
余祖辉,陈丙辰,伍晓文, 等. 经尿道前列腺电切术同期行腹股沟疝修补术治疗BPH合并腹股沟疝临床研究[J]. 海南医学, 2020, 31(8): 1000-1002.
[12]
王步云,雷磊. 疝气无张力修补术治疗老年腹股沟疝患者的效果[J]. 实用临床医药杂志, 2020, 24(8): 104-106.
[13]
蒋智明,徐恩,夏雪峰, 等. 超声对隐匿性腹股沟疝的诊断价值[J]. 中华实用诊断与治疗杂志, 2020, 34(7): 726-727.
[14]
郑学裕,李育智,王超, 等. 高频超声诊断腹股沟疝的影像学特征与手术结果符合率分析[J/OL]. 中华疝和腹壁外科杂志(电子版), 2020, 14(2): 185-188.
[15]
Niebuhr H, König A, Pawlak M, et al. Groin hernia diagnostics: dynamic inguinal ultrasound(DIUS)[J]. Langenbecks Arch Surg, 2017, 402(7): 1039-1045.
[16]
Towfigh S. Inguinal Hernia: Four Open Approaches[J]. Surg Clin North Am, 2018, 98(3): 623-636.
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