【摘要】 目的：探讨彩色多普勒超声根据疝囊与腹壁下动脉关系在腹股沟直疝、斜疝鉴别诊断中的准确性及应用价值。方法：回顾性分析在莱州市人民医院超声诊断为腹股沟疝并进行腹腔镜修补术的146例患者，共151处侧腹股沟疝。其中，斜疝113例，直疝32例，符合疝4例，股疝2例。所有入选者均通过彩色多普勒超声检查并鉴别直疝、斜疝及股疝，超声记录疝的内容物，有无积液、有无崁顿、疝囊与腹壁下动脉的位置关系。分析彩色多普勒超声根据疝囊与腹壁下动脉位置关系对腹股沟疝的诊断效能。结果：术后腹腔镜诊断腹股沟斜疝113例，直疝32例，复合疝4例，股疝2例；彩超多普勒超声诊断斜疝113例，直疝36例，股疝2例，复合疝0例。超声诊断斜疝的符合率约93.38%、直疝的符合率约93.38%，超声诊断斜疝的灵敏度约95.58%、直疝的灵敏度约90.63%，超声诊断斜疝的特异性约86.84%、直疝的特异性约94.12%，超声诊断斜疝的阳性预测值约95.58%、直疝的阳性预测值80.56%，超声诊断斜疝的误诊率约13.16%、直疝的误诊率约5.88%，超声诊断斜疝的漏诊率约4.44%、直疝的漏诊率约9.38%。结论：彩色多普勒超声能够清晰显示疝囊与腹壁下动脉的位置关系，从而可以准确鉴别斜疝与直疝，继而有效指导腹腔镜疝修补术。更多还原

【Abstract】 Objective: To investigate the accuracy and application value of color doppler ultrasound in the differential diagnosis of direct inguinal hernia and indirect inguinal hernia according to the relationship between hernia sac and inferior epigastric artery. Methods: A total of 146 patients with inguinal hernia diagnosed by ultrasound and underwent laparoscopic repair in Laizhou People’s Hospital were retrospectively analyzed. A total of 151 inguinal hernias were studied, including 113 cases of indirect hernia,32 cases of direct hernia, 4 cases of mixed hernia and 2 cases of femoral hernia. All patients were examined by color Doppler ultrasound to identify direct hernia, indirect hernia and femoral hernia. Ultrasound recorded the contents of the hernia, with or without effusion, with or without incarceration, and the positional relationship between the hernia sac and the inferior epigastric artery. The diagnostic efficacy of color Doppler ultrasound for inguinal hernia according to the positional relationship between hernia sac and inferior epigastric artery was analyzed. Results: Postoperative laparoscopy diagnosed 113 cases of indirect inguinal hernia, 32 cases of direct hernia, 4 cases of compound hernia, and 2 cases of femoral hernia. Color Doppler ultrasonography diagnosed 113 cases of indirect hernia, 36 cases of direct hernia, 2cases of femoral hernia, and 0 case of compound hernia. The coincidence rate of ultrasound diagnosis of indirect hernia was about 93.38%, the coincidence rate of direct hernia was about 93.38%, the sensitivity of ultrasound diagnosis of indirect hernia was about 95.58%, the sensitivity of direct hernia was about 90.63%, the specificity of ultrasound diagnosis of indirect hernia was about 86.84%, the specificity of direct hernia was about 94.12%, the positive predictive value of ultrasound diagnosis of indirect hernia was about 95.58%, the positive predictive value of direct hernia was 80.56%, the misdiagnosis rate of ultrasound diagnosis of indirect hernia was about 13.16%, the misdiagnosis rate of direct hernia was about 5.88%, the missed diagnosis rate of ultrasound diagnosis of indirect hernia was about 4.44%, and the missed diagnosis rate of direct hernia was about 9.38%. Conclusion: Color Doppler ultrasound can clearly show the position relationship between the hernia sac and the inferior epigastric artery, which can accurately identify indirect hernia and direct hernia, and then effectively guide laparoscopic hernia repair.更多还原