【摘要】 目的　探讨慢性胆囊炎急性发作患者胆囊壁改变的声像图表现。方法　将 1 0 5例急诊手术后病理诊断为慢性胆囊炎急性发作与急性胆囊炎 (各型 )患者超声测量的囊壁厚度进行对照 ,分析囊壁厚度与疼痛发作时间长短的关系 ,观察“双环”征出现率及胆囊壁光滑度。结果　慢性胆囊炎急性发作 91例 ,其中壁厚≤ 0 .3cm者 71例 ,占 78.0 % ,化脓性及坏疽性胆囊炎 1 1例 ,慢性胆囊炎 3例。出现“双环”征在慢性胆囊炎急性发作者中为 1 4例 ,化脓性及坏疸性胆囊炎中 7例。囊壁毛糙在慢性胆囊炎急性发作 1 1例 ,化脓性及坏疸性胆囊炎中 8例。结论　在急诊就诊的胆囊炎患者中慢性胆囊炎急性发作较多见。其囊壁声像图特点为 :疼痛发作初期囊壁薄 (≤ 0 .3cm)、光整 ,此阶段在急诊超声中较多见 ,随病程进展 ,囊壁增厚 ( >0 .3cm)及“双环”征出现机率增高。基于此现象与文献报道的急性胆囊炎囊壁超声诊断指标差异较大 ,故需引起注意 ,以免漏诊和误诊。更多还原

【Abstract】 Objective To investigate the features of sonograph of gallbladder wall for chronic cholecystitis with acute exacerbation(CCAE).Methods The thickness of gallbadder wall of 105 cases pathologically diagnosed as CCAE were examined by ultrasonography and compared with those of acute cholecystitis (AC).The ralationship between the thickness of gallbladder wall with ache lasting time was analyzed.“Double ring”sign and smooth degree of gallbladder wall were also discussed.Results Among 91 cases of CCAE,there were 71 cases whose thickness of gallbladder wall were less than 0.3 cm ( 78.0 %).Eleven cases were septic and gangrenous cholecystitis.Three cases were chronic cholecystitis.There were 14 cases of CCAE and 7 cases of septic and gangrenous cholecystitis with “double ring”sign.There were 11 cases of CCAE and 8 cases of septic and gangrenous cholecystitis without gallbladder wall smooth.Conclusions CCAE is a very common disease among all the acute cholecystitis patients. The features of sonograph of CCAE are that the gallbadder wall is thin(less than 0.3 cm) and tidy at the beginning of the illness and can always be observed in emergency call ultrasonography. With the progress of CCAE,the thickness of gallblader wall and appearing rate of “double ring”sign are increased.更多还原