切换至 "中华医学电子期刊资源库"

中华疝和腹壁外科杂志(电子版) ›› 2021, Vol. 15 ›› Issue (05) : 466 -470. doi: 10.3877/cma.j.issn.1674-392X.2021.05.006

临床论著

多层螺旋CT扫描与图像后处理在腹股沟疝术前分型的评估效能
王隽1,(), 宁飞龙1, 张颢1, 刘阳1, 权红光1, 严金明1   
  1. 1. 221009 江苏省,徐州市中医院普外科
  • 收稿日期:2021-01-05 出版日期:2021-10-14
  • 通信作者: 王隽

Efficiency analysis of multi-slice spiral CT scanning and image post-processing in preoperative classification of groin hernia patients

Jun Wang1,(), Feilong Ning1, Hao Zhang1, Yang Liu1, Hongguang Quan1, Jinming Yan1   

  1. 1. Department of General Surgery, Xuzhou Traditional Chinese Medicine Hospital, Xuzhou 221009, China
  • Received:2021-01-05 Published:2021-10-14
  • Corresponding author: Jun Wang
引用本文:

王隽, 宁飞龙, 张颢, 刘阳, 权红光, 严金明. 多层螺旋CT扫描与图像后处理在腹股沟疝术前分型的评估效能[J]. 中华疝和腹壁外科杂志(电子版), 2021, 15(05): 466-470.

Jun Wang, Feilong Ning, Hao Zhang, Yang Liu, Hongguang Quan, Jinming Yan. Efficiency analysis of multi-slice spiral CT scanning and image post-processing in preoperative classification of groin hernia patients[J]. Chinese Journal of Hernia and Abdominal Wall Surgery(Electronic Edition), 2021, 15(05): 466-470.

目的

探讨分析多层螺旋计算机断层扫描(MSCT)与图像后处理在腹股沟疝术前分型评估中的效能。

方法

回顾性分析2015年1月至2019年8月,徐州市中医院采用腹腔镜经腹腹膜前疝修补术(TAPP)治疗的腹股沟疝86例患者的临床资料,术前均采用MSCT与图像后处理检查,进行分型评估,统计不同分型患者的影像学表现特点及分型结果,并将腹腔镜术中所见分型作为标准,采用Kappa检验分析MSCT与图像后处理检查结果和腹腔镜术中所见结果的一致性。

结果

MSCT与图像后处理术前分型评估和腹腔镜术中分型结果:术前斜疝77例,Ⅰ型29例、Ⅱ型41例、Ⅲ型7例;术中Ⅰ型30例、Ⅱ型40例、Ⅲ型8例;术前直疝5例,Ⅳ型2例、Ⅴ型3例,术中Ⅳ型1例、Ⅴ型4例;术前马鞍疝Ⅵ型3例,术中Ⅵ型2例;术前股疝Ⅶ型1例,术中Ⅶ型1例。斜疝、直疝、马鞍疝和股疝患者MSCT与图像后处理术前分型结果与腹腔镜术中分型的符合率分别为93.48%、100%、79.43%、100%;MSCT与图像后处理腹股沟疝术前分型和腹腔镜术中分型一致性良好(Kappa=0.9106,P<0.05)。

结论

MSCT与图像后处理在腹股沟疝术前分型评估中效能高,与腔镜术中所见分型结果高度一致。

Objective

To explore and analyze the efficacy of multi-slice spiral computed tomography (MSCT) scanning and image post-processing in preoperative classification of groin hernia patients.

Methods

The clinical data of 86 cases of adult groin hernia treated by laparoscopic trans-abdominal preperitoneal hernia repair (TAPP) in Xuzhou Traditional Chinese Medicine Hospital from January 2015 to August 2019 were retrospectively analyzed. MSCT and image post-processing were used to evaluate the classification before operation. The imaging features and classification results of patients with different types were counted, and the classification seen in laparoscopy was regarded as the standard. Kappa test was used to analyze the consistency between MSCT and image post-processing examination results and intraoperative findings.

Results

The results of MSCT and image post-processing examination before typing were 77 cases of indirect groin hernia, type Ⅰ in 29 cases, type Ⅱ in 41 cases, type Ⅲ in 7 cases, the results of laparoscopic typing were: type Ⅰ in 30 cases, type Ⅱ in 40 cases, type Ⅲ in 8 cases; The results of MSCT and image post-processing examination before typing were 5 cases of direct groin hernia, type Ⅳ in 2 cases, type Ⅴ in 3 cases, the results of laparoscopic typing were: type Ⅳ in 1 case, type Ⅴ in 4 cases; The results of MSCT and image post-processing examination before typing were 3 cases of groin saddle hernia, type Ⅵ in 3 cases, the results of laparoscopic typing were: type VI in 2 cases; The results of MSCT and image post-processing examination before typing were 1 case of femoral hernia (type Ⅶ), the results of laparoscopic typing were: type Ⅶ in 1 case. The coincidence rates of MSCT and image post-processing preoperative typing and laparoscopic typing were 93.48%, 100%, 79.43%, 100% for indirect groin hernia, direct groin hernia, groin saddle hernia and femoral hernia, respectively. According to Kappa test, MSCT had good consistency with preoperative and laparoscopic classification of indirect groin hernia, direct groin hernia, groin saddle hernia and femoral hernia after image processing (Kappa=0.9106, P<0.05).

Conclusion

MSCT and image post-processing are highly effective in evaluating preoperative classification of groin hernia patients by laparoscopy, and are highly consistent with the results of intraoperative classification.

表1 MSCT与图像后处理术前分型(斜疝和直疝)
表2 术中腔镜分型诊断结果(斜疝和直疝)
表3 MSCT与图像后处理术前分型和术中腔镜分型诊断结果统计
[1]
中华医学会外科学分会疝与腹壁外科学组,中国医师协会外科医师分会疝和腹壁外科医师委员会. 成人腹股沟疝诊断和治疗指南(2018年版)[J]. 中华外科杂志, 2018, 56(7): 495.
[2]
唐健雄,华蕾,张逖, 等. 成人腹股沟疝患病情况的多中心研究[J]. 外科理论与实践, 2002, 7(6): 421-422.
[3]
秦昌富,李炳根,申英末, 等. 中国疝病注册登记随访系统的建立和发展[J]. 外科理论与实践, 2018, 23(4): 295-298.
[4]
LeBlanc KA, Allain BW, Streetman WC. Laparoscopic Inguinal Hernia repair[M]//Kingsnorth AN, LeBlanc KA,. Management of Abdominal Hernias. London: Springer, 2013: 265-277.
[5]
Eklund A, Calsson P. Long-term Cost Minimization analysis compairng laparoscopic with open(Lichtenstien) inguinal hernia[J]. Br J Surg, 2010, 97(5): 765-771.
[6]
崔兆清,章阳. 无张力腹股沟疝修补手术个体化处理[J/OL]. 中华普通外科学文献(电子版), 2014, 8(4): 267-269.
[7]
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.
[8]
中国医师协会外科医师分会疝和腹壁外科医师委员会. 成人腹股沟疝诊疗指南(2014年版)[J]. 中国实用外科杂志, 2015, 52(14): 484-486.
[9]
Gilbert L. An anatomic and functional classification for the diagnosis and treatment of inguinal hernia[J]. Am J Surg, 1989, 157(3): 331-333.
[10]
中华外科学会疝和腹壁外科学组. 成人腹股沟疝、股疝手术治疗方案(修改稿)[J]. 中华普通外科杂志, 2004, 19(2): 162.
[11]
Kingsnorth A. Treating inguinal hernias[J]. BMJ, 2004, 328(7431): 59-60.
[12]
Zollinger RM Jr. An updated traditional classification of inguinal hernias[J]. Hernia, 2004, 8(4): 318-322.
[13]
Burkhardt JH, Arshanskiy Y, Munson JL, et al. Diagnosis of inguinal region hernias with axial CT: the lateral crescent sign and other key findings[J]. Radiographics, 2011, 31: E1-12.
[14]
Lilly MC, Arregui ME. Ultrasound of the inguinal floor for evaluation of hernias[J]. Surg Endosc, 2002, 16(4): 659-662.
[15]
Bradley M, Morgan D, Pentlow B, et al. The groin hernia-an ultrasound diagnosis?[J]. Ann R Coll Surg Engl, 2003, 85(3): 178-180.
[16]
侯泽辉,江志鹏,李雯莉,等.不同体位CT检查对腹壁切口疝容积评估的影响[J]. 中华消化外科杂志, 2019,18(11):1075-1079.
[17]
朱止平,窦文广,岳军艳,等.成人腹股沟斜疝与直疝和股疝的多排螺旋CT检查影像学特征[J]. 中华消化外科杂志, 2018,17(11):1127-1133.
[18]
王隽,张汉超,权红光, 等. 腹腔镜经腹腹膜前疝修补术疝囊横断与剥离治疗Ⅲ型腹股沟斜疝的疗效[J/OL]. 中华疝和腹壁外科杂志(电子版), 2019, 13(3): 204-206.
[19]
Fataar S. CT of inguinal canal lipomas and fat-containing inguinal hernias[J]. J Med Imaging Radiat Oncol, 2011, 55(5): 485-492.
[1] 代莉, 邓恢伟, 郭华静, 黄芙蓉. 术中持续输注艾司氯胺酮对腹腔镜结直肠癌手术患者术后睡眠质量的影响[J]. 中华普通外科学文献(电子版), 2023, 17(06): 408-412.
[2] 李凯, 陈淋, 向涵, 苏怀东, 张伟. 一种U型记忆合金线在经脐单孔腹腔镜阑尾切除术中的临床应用[J]. 中华普外科手术学杂志(电子版), 2024, 18(01): 15-15.
[3] 杜晓辉, 崔建新. 腹腔镜右半结肠癌D3根治术淋巴结清扫范围与策略[J]. 中华普外科手术学杂志(电子版), 2024, 18(01): 5-8.
[4] 周岩冰, 刘晓东. 腹腔镜右半结肠癌D3根治术消化道吻合重建方式的选择[J]. 中华普外科手术学杂志(电子版), 2024, 18(01): 9-13.
[5] 张焱辉, 张蛟, 朱志贤. 留置肛管在中低位直肠癌新辅助放化疗后腹腔镜TME术中的临床研究[J]. 中华普外科手术学杂志(电子版), 2024, 18(01): 25-28.
[6] 王春荣, 陈姜, 喻晨. 循Glisson蒂鞘外解剖、Laennec膜入路腹腔镜解剖性左半肝切除术临床应用[J]. 中华普外科手术学杂志(电子版), 2024, 18(01): 37-40.
[7] 李晓玉, 江庆, 汤海琴, 罗静枝. 围手术期综合管理对胆总管结石并急性胆管炎患者ERCP +LC术后心肌损伤的影响研究[J]. 中华普外科手术学杂志(电子版), 2024, 18(01): 57-60.
[8] 甄子铂, 刘金虎. 基于列线图模型探究静脉全身麻醉腹腔镜胆囊切除术患者术后肠道功能紊乱的影响因素[J]. 中华普外科手术学杂志(电子版), 2024, 18(01): 61-65.
[9] 逄世江, 黄艳艳, 朱冠烈. 改良π形吻合在腹腔镜全胃切除消化道重建中的安全性和有效性研究[J]. 中华普外科手术学杂志(电子版), 2024, 18(01): 66-69.
[10] 曹迪, 张玉茹. 经腹腔镜生物补片修补直肠癌根治术后盆底疝1例[J]. 中华普外科手术学杂志(电子版), 2024, 18(01): 115-116.
[11] 易明超, 汪鑫, 向涵, 苏怀东, 张伟. 一种T型记忆金属线在经脐单孔腹腔镜胆囊切除术中的临床应用[J]. 中华普外科手术学杂志(电子版), 2023, 17(06): 599-599.
[12] 叶晋生, 路夷平, 梁燕凯, 于淼, 冀祯, 贺志坚, 张洪海, 王洁. 腹腔镜下应用生物补片修补直肠术后盆底缺损的疗效[J]. 中华疝和腹壁外科杂志(电子版), 2023, 17(06): 688-691.
[13] 王可, 范彬, 李多富, 刘奎. 两种疝囊残端处理方法在经腹腹膜前腹股沟疝修补术中的疗效比较[J]. 中华疝和腹壁外科杂志(电子版), 2023, 17(06): 692-696.
[14] 袁伟, 张修稳, 潘宏波, 章军, 王虎, 黄敏. 平片式与填充式腹股沟疝修补术的疗效比较[J]. 中华疝和腹壁外科杂志(电子版), 2023, 17(06): 697-701.
[15] 夏松, 姚嗣会, 汪勇刚. 经腹腹膜前与疝环充填式疝修补术治疗腹股沟疝的对照研究[J]. 中华疝和腹壁外科杂志(电子版), 2023, 17(06): 702-705.
阅读次数
全文


摘要