【摘要】 目的　为探讨急性胆囊炎并发胆囊穿孔的超声诊断价值 ,对我院收治的 8例上述患者资料进行了回顾性分析。方法　 8例急性胆囊炎并发胆囊穿孔患者 ,男 3例、女 5例 ,年龄 5 5～ 83岁 ,平均年龄 (6 7.2 5±9.6 0 )岁。使用东芝 6 0 0 0型超声诊断仪 ,探头频率 3.5～ 6 .0 MHz,患者取平卧位或左侧卧位检查。结果　 8例穿孔患者胆囊壁连续性中断 ,缺损大小在 0 .2 cm～ 1 .1 cm不等 ,其周围可见局限性积液 ,范围在 0 .8cm× 0 .9cm～ 5 .1 cm× 3.4 cm。囊内均可见结石影像 ,1例合并有胆总管结石 ,另 1例合并胆总管肿瘤。 8例患者胆囊腔内均可见密集点状回声 ,为淤积的胆汁影像。穿孔的部位 :1例位于胆囊底部 ,3例位于体部 ,4例位于颈部。结论　在急性胆囊炎并发胆囊穿孔的病例中 ,应用超声全面细致地检查不仅可直观迅速地明确有无穿孔、穿孔的部位、大小以及腹腔积液的情况 ,可动态观察 ,对疗效评估并适时调整治疗 ,有一定的价值更多还原

【Abstract】 Objective In order to approach the value of ultrasonic diagnosis for acute cholecystitis complicated with perforation of gallbladder,we have retrospectively analyzed 8 patients with above mentioned disease admitted into our hospital. Methods Eight patients with acute cholecystitis complicated with perforation of gallbladder including 3 men and 5 women(aged from 55 to 83,average,67 25±9 60).The patients were examined on horizontal position or left lateral horizontal position using Toshiba 6000 type ultrasonic diagnostic apparatus equipped with 3 5 6 0 MHz probe. Results Gallbladder wall continuation was interrupted in 8 patients with perforation of gallbladder.The deficit size of the wall varied and hydrops from 0 8×0 9 2-5 1×3 4 cm 2 could be seen around the deficit.Images of lithiasis were seen in all gallbladders.One case was complicated with choledocholith,another case with choledochal tumor and 8 cases with dense dot like echoes of bile stasis in the gallbladder.The positions of the perforation were:one case located at the bottom of the gallbladder,three cases at the body of the gallbladder and four cases located at the neck of the gallbladder. Conclusions By overall and careful examining the patients with acute cholecystitis complicated with perforation of gallbladder using ultrasound,we can not only directly and rapidly determine the presence,position and size of the perforation and the condition of hydrops in the abdominal cavity,but also can observe dynamical changes.Therefore ultrasound is valuable for evaluation of curative effect and for timely adjusting treatment.更多还原