本文選題：超聲診斷 + 自動超聲容積斷層掃描　； 參考：《復(fù)旦大學(xué)》2012年碩士論文

【摘要】：本課題通過回顧性分析研究傳統(tǒng)超聲檢查和自動超聲容積斷層掃描在圍手術(shù)期診斷腹外疝的應(yīng)用價值,并進一步比較兩種檢查在腹外疝不同分類中的診斷優(yōu)勢,旨在為臨床提供最有效、最簡單、最快捷的影像診斷依據(jù)。 第一部分：研究傳統(tǒng)超聲檢查對腹股溝疝手術(shù)前后評估的價值。方法：對30名患者32例腹股溝疝于手術(shù)前后進行二維超聲檢查。術(shù)前觀察內(nèi)環(huán)位置、腹股溝管內(nèi)徑改變、疝囊大小及內(nèi)容物并對腹股溝疝類型進行分類；術(shù)后觀察補片位置、大小、形態(tài)及生物補片與四周組織的融合情況。結(jié)果：在32例病例中,有20例斜疝、4例直疝、3例股疝術(shù)前的超聲診斷與手術(shù)結(jié)果相符。術(shù)后一個月內(nèi)超聲檢查發(fā)現(xiàn),其中28例見正常生物補片、未見其他異�；芈�,2例見補片外血腫,1例見補片外復(fù)發(fā)疝,1例見補片變形。結(jié)論：在腹股溝疝手術(shù)前,通過超聲檢查能為臨床醫(yī)生提供腹股溝疝形態(tài)的詳細(xì)參考數(shù)據(jù)并為腹股溝疝分類,為臨床醫(yī)生選擇適合患者個體的生物補片提供了重要的客觀依據(jù)。在腹股溝疝手術(shù)后,超聲檢查能觀察生物補片的形態(tài)、位置及有無發(fā)生其它并發(fā)癥。 第二部分：研究自動超聲容積斷層掃描在腹外疝分類診斷中的應(yīng)用價值。方法：術(shù)前對62例疑似腹外疝進行自動超聲容積斷層掃描(簡稱AUVS)檢查,通過AUVS的任意切面(橫斷面、矢狀面、冠狀面)對掃查區(qū)域的立體結(jié)構(gòu)、疝環(huán)位置、疝囊、疝內(nèi)容物及回納途徑進行觀察,診斷出腹外疝的類型,并將診斷結(jié)果與術(shù)后診斷進行比較。結(jié)果：在對腹外疝病例的診斷分類中,AUVS對腹壁切口疝的診斷正確率高于AUVS對腹股溝疝的診斷；AUVS對難復(fù)性腹股溝疝的診斷正確率高于AUVS對可復(fù)性腹股溝疝的診斷。結(jié)論：AUVS顯示的組織冠狀面圖像,能為臨床醫(yī)生提供了立體三維的客觀影像學(xué)數(shù)據(jù)；在腹外疝的診斷分類中,AUVS對腹壁切口疝和難復(fù)性腹股溝疝的診斷可給予明確的影像學(xué)支持依據(jù)。 第三部分：通過臨床研究,比較自動超聲容積斷層掃描和傳統(tǒng)超聲檢查在腹外疝中分類診斷的應(yīng)用優(yōu)勢。方法：術(shù)前對83例疑為腹外疝患者分別進行自動超聲容積斷層掃描及傳統(tǒng)超聲檢查,通過UVAS的切面(橫斷面、矢狀面、冠狀面)以及傳統(tǒng)超聲的二維圖像和彩色多普勒技術(shù),對腹外疝的立體結(jié)構(gòu)、疝環(huán)位置、疝囊、疝內(nèi)容物及回納途徑進行觀察,判斷其的類型,并將診斷結(jié)果與術(shù)后診斷進行對照。結(jié)果：對于腹外疝不同分類的診斷,UVAS診斷腹壁切口疝和難復(fù)性腹股溝疝的符合率更高,傳統(tǒng)超聲檢查診斷可復(fù)性腹股溝疝的符合率更高。結(jié)論：兩種不同的檢查方法比較,UVAS對腹壁切口疝和難復(fù)性腹股溝疝的診斷比傳統(tǒng)超聲檢查更具優(yōu)勢。兩種檢查方法有效結(jié)合,將為臨床明確診斷腹外疝提供最有效、最便捷的影像依據(jù)。
[Abstract]:The purpose of this paper is to study the value of traditional ultrasonography and automatic ultrasound volume tomography in the diagnosis of abdominal external hernia during perioperative period, and to compare the advantages of the two kinds of examinations in different classification of external abdominal hernia. The aim is to provide the most effective, the simplest and the quickest diagnostic basis for clinical imaging. Part one: to study the value of traditional ultrasonography in evaluation of inguinal hernia before and after operation. Methods: 32 patients with inguinal hernia were examined by two-dimensional ultrasound before and after operation. The position of the internal ring, the diameter of the inguinal tube, the size and contents of the hernia sac were observed before operation and the types of inguinal hernia were classified, and the position, size, morphology and fusion of the patch with the surrounding tissues were observed after operation. Results: among 32 cases, 20 cases had indirect hernia 4 cases had direct hernia and 3 cases had femoral hernia. Ultrasonic examination within one month after operation showed that 28 cases had normal biological patch, 2 cases had no other abnormal echo and 1 case had recurrent hernia and 1 case had deformation. Conclusion: before inguinal hernia operation, ultrasonic examination can provide the detailed reference data of inguinal hernia morphology for clinicians, and provide important objective basis for clinicians to select biological patch suitable for individual patients. After inguinal hernia operation, ultrasonic examination can observe the morphology, location and other complications of biological patch. Part two: to study the application value of automatic ultrasound volume tomography in classification diagnosis of abdominal external hernia. Methods: 62 cases of suspected external abdominal hernia were examined by automatic ultrasound volume tomography (AUVs) before operation. The three-dimensional structure, position of hernia ring and hernia sac were examined by any section (cross section, sagittal plane, coronal plane) of AUVS. The hernia contents and resuscitation pathway were observed and the types of external abdominal hernia were diagnosed and compared with postoperative diagnosis. Results: in the classification of external abdominal hernia, the diagnostic accuracy of AUVS for incisional hernia of abdominal wall was higher than that of AUVS for refractory hernia of inguinal hernia, which was higher than that of AUVS for the diagnosis of reducible inguinal hernia. Conclusion the coronal images of tissues displayed by the 10% AUVS can provide the three-dimensional and objective imaging data for the clinicians. In the diagnosis classification of external abdominal hernia, AUVS can provide definite imaging support for the diagnosis of incisional hernia and inguinal hernia. Part three: through clinical research, the advantages of automatic ultrasound volume tomography and traditional ultrasound in the classification diagnosis of external abdominal hernia are compared. Methods: 83 patients with suspected external abdominal hernia were examined by automatic volume tomography and traditional ultrasound respectively. The UVAS section (transverse, sagittal, coronal) and the color Doppler technique of traditional ultrasound were used. The stereoscopic structure, location of herniation ring, hernia sac, hernia contents and resuscitation pathway of external abdominal hernia were observed, the types of hernia were judged, and the diagnostic results were compared with postoperative diagnosis. Results: the coincidence rate of UVAS in the diagnosis of incisional hernia and refractory inguinal hernia was higher than that of traditional ultrasonography. Conclusion: UVAS is superior to traditional ultrasound in the diagnosis of incisional hernia and inguinal hernia. The effective combination of the two methods will provide the most effective and convenient imaging basis for the clinical diagnosis of abdominal external hernia.
【學(xué)位授予單位】：復(fù)旦大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2012
【分類號】：R445.1;R816.5;R656.2

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