临床普外科电子杂志 ›› 2025, Vol. 13 ›› Issue (3): 55-.

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超声实时监测阑尾切除术后早期并发症的临床价值研究

  

  1. 桂林市人民医院 超声科,广西 桂林 541002
  • 出版日期:2025-07-01 发布日期:2025-11-20

Clinical value of ultrasound real-time monitoring of early complications after appendectomy

  1. Ultrasound Department of Guilin People's Hospital, Guangxi Guilin 541002, China
  • Online:2025-07-01 Published:2025-11-20

摘要:

目的 探讨超声实时监测阑尾切除术后早期并发症的价值。方法 回顾性分析 2023 年 1 月至 2024 年 12 月在桂林市人民医院行阑尾切除术后出现并发症的 60 例患者的临床与超声资料。记录并总结各类并发症的声像图特征。结果 60 例出现并发症的阑尾切除术患者中,腹水 16 例,腹腔脓肿 12 例,切口感染 23 例,阑尾残株炎 6 例,肠梗阻 3 例,均结合手术、穿刺或临床随访结果验证诊断。腹水的超声特征为边界清晰的无回声或弱回声区,形态多呈带状或不规则片状;腹腔脓肿的超声特征为边界不规则的混合回声团,内部回声不均匀,可见絮状、网状或条索状强回声,部分合并液 - 液平面或气泡样强回声并伴后方“彗尾征”声影;切口感染的超声特征为皮下组织回声增粗、排列紊乱,层次结构模糊不清,局部可见片状或不规则低回声区;阑尾残株炎的超声特征为盲肠根部邻近区域出现一条索状盲端结构,直径增粗,平均横径为 8.4mm(范围 7.2 ~ 10.1mm),呈低至中等回声,内部回声不均,可见管腔内点状或条状高回声;肠梗阻的超声特征为典型的肠管扩张与液气积聚表现。结论 超声在阑尾切除术后早期并发症的识别中具有重要价值,能够通过动态、无创的方式及时发现术后异常改变,对判断病变性质、评估炎症活动及指导临床干预具有现实意义。

关键词: 超声, 实时监测, 阑尾切除术, 并发症

Abstract:

Objective To investigate the value of ultrasound real-time monitoring in early complications after appendectomy. Method The clinical and ultrasonic data of 60 patients with complications after appendectomy in Guilin People's Hospital from January 2023 to December 2024 were retrospectively analyzed. The sonographic characteristics of various complications were recorded and summarized. Result Among the 60 patients with complications after appendectomy, there were 16 cases of ascites, 12 cases of abdominal abscess, 23 cases of incision infection, 6 cases of appendicitis stump, and 3 cases of intestinal obstruction. The diagnosis was verified by the results of operation, puncture or clinical follow-up. The ultrasonic characteristics of ascites were clear-cut anechoic or hypoechoic areas, which were mostly banded or irregular flakes; The ultrasonic characteristics of abdominal abscess were mixed echo masses with irregular boundaries, uneven internal echo, flocculent, reticular or cord like strong echo, some of which were combined with liquid-liquid plane or bubble like strong echo and accompanied by rear "comet tail sign" sound shadow; The ultrasonic features of incision infection were thickened and disordered echo of subcutaneous tissue, blurred hierarchical structure, and patchy or irregular hypoechoic areas were seen locally; The ultrasonic characteristics of appendicitis stump were as follows: a cord like blind end structure appeared in the area adjacent to the root of the cecum, the diameter was thickened, the average transverse diameter was 8.4mm (range 7.2 ~ 10.1mm), low to medium echo, uneven internal echo, and spot or strip hyperechoic in the lumen could be seen; The ultrasonic characteristics of intestinal obstruction were typical intestinal dilatation and fluid gas accumulation. Conclusion Ultrasound has important value in the identification of early complications after appendectomy. It can detect abnormal changes in time through dynamic and noninvasive ways, and has practical significance in judging the nature of lesions, evaluating inflammatory activities and guiding clinical intervention.

Key words: Ultrasound, Real-time monitoring, Appendectomy, Complications