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中华疝和腹壁外科杂志(电子版) ›› 2023, Vol. 17 ›› Issue (05) : 615 -618. doi: 10.3877/cma.j.issn.1674-392X.2023.05.025

论著

腹股沟疝与股疝的超声征象及鉴别诊断价值分析
张霄峰(), 王军   
  1. 239300 安徽省天长市中医院超声科
  • 收稿日期:2023-01-13 出版日期:2023-10-18
  • 通信作者: 张霄峰
  • 基金资助:
    滁州市卫生健康适宜技术推广项目(cztg-202105)

Analysis of ultrasonic signs of inguinal hernia and femoral hernia and their differential diagnosis value

Xiaofeng Zhang(), Jun Wang   

  1. Department of Ultrasound, Tianchang City Hospital of Traditional Chinese Medicine, Anhui Province, Tianchang 239300, China
  • Received:2023-01-13 Published:2023-10-18
  • Corresponding author: Xiaofeng Zhang
引用本文:

张霄峰, 王军. 腹股沟疝与股疝的超声征象及鉴别诊断价值分析[J]. 中华疝和腹壁外科杂志(电子版), 2023, 17(05): 615-618.

Xiaofeng Zhang, Jun Wang. Analysis of ultrasonic signs of inguinal hernia and femoral hernia and their differential diagnosis value[J]. Chinese Journal of Hernia and Abdominal Wall Surgery(Electronic Edition), 2023, 17(05): 615-618.

目的

探讨腹股沟疝及股疝的超声征象及其鉴别诊断价值。

方法

回顾性分析2020年10月至2021年12月,安徽省天长市中医院收治的60例疑似腹股沟疝或股疝的患者,均接受超声检查和手术探查。分析腹股沟疝及股疝的的超声征象特征;以手术探查结果为金标准,分析超声诊断及鉴别诊断结果与手术探查诊断结果的Kappa一致性。

结果

经手术探查,共确诊腹股沟疝及股疝55例,其中腹股沟斜疝45例、腹股沟直疝6例、股疝4例,另5例分别为2例腹壁脂肪瘤、2例鞘膜积液和1例隐睾。以手术探查诊断结果为金标准,超声诊断腹股沟疝及股疝的敏感度、特异度为92.73%、80.00%(Kappa=0.571);超声鉴别诊断腹股沟斜疝、腹股沟直疝、股疝的准确度为90.91%(Kappa=0.768);超声鉴别诊断鞘膜积液、腹壁脂肪瘤、隐睾的准确度为80.00%(Kappa=0.706)。

结论

超声对腹股沟疝及股疝的诊断、分型具有重要价值,是腹股沟疝及股疝鉴别诊断的首选影像学检查方法。

Objective

To explore the ultrasonic signs of inguinal hernia and femoral hernia, and their differential diagnosis value.

Methods

A retrospective analysis was performed on 60 patients with suspected inguinal hernia or femoral hernia admitted to Tianchang City Hospital of Traditional Chinese Medicine between October 2020 and December 2021. All underwent ultrasonography and surgical exploration. The ultrasonic signs and characteristics of inguinal hernia and femoral hernia were analyzed. Taking results of surgical exploration as the golden standard, the Kappa consistency of diagnosis results between ultrasound and surgical exploration was analyzed.

Results

Surgical exploration showed that there were 55 patients with inguinal hernia or femoral hernia, including 45 cases with indirect hernia, 6 cases with direct hernia and 4 cases with femoral hernia. There are 5 patients without inguinal hernia or femoral hernia, including 2 cases with abdominal wall lipoma, 2 cases with hydrocele and 1 case with cryptorchidism. Taking the results of surgical exploration as the golden standard, the sensitivity and specificity of ultrasound in the diagnosis of inguinal hernia and femoral hernia were 92.73% and 80.00%, respectively (Kappa=0.571). The accuracy of ultrasound in the differential diagnosis of indirect hernia, direct hernia and femoral hernia was 90.91% (Kappa=0.768). The accuracy of ultrasound in the differential diagnosis of hydrocele, abdominal wall lipoma and cryptorchidism was 80.00% (Kappa=0.706), respectively.

Conclusion

Ultrasound is of great value in the diagnosis and classifications of inguinal hernia and femoral hernia, which is the first choice for the differential diagnosis of inguinal hernia and femoral hernia.

图1 不同类型腹股沟疝及股疝的典型超声征象图注:1A直疝。左侧腹股沟区可见一大小约4.4 cm×1.9 cm的欠规则异常强回声团块,边界清,其间尚可见闪动的气体回声和肠蠕动。1B斜疝。右侧腹股沟区内异常强回声团块,大小约4.6 cm×2.6 cm,边界清晰,可见气体回声和肠管蠕动的异常团块回声。1C股疝。右侧腹股沟区内可见一大小约4.6 cm×1.3 cm的边界清异常混合回声团块。
表1 超声与手术诊断结果的一致性
表2 超声鉴别诊断分型结果与手术诊断结果的Kappa一致性
表3 超声鉴别诊断其他结果与手术诊断结果的Kappa一致性
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