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1、临床不典型急性阑尾炎的超声诊断杨力张万蕾宋奕宁王雪李建国杨力，张万蕾，宋奕宁，王雪，李建国，北京大学人民医院超声科北京市100044杨力，女，1969-12-01生，北京人,汉族。2007年北京大学硕士，主治医师。主要从事腹部疾病及血管疾病的超声诊断。作者贡献分布：此课题立题由杨力完成;设计由杨力与张万蕾完成;研究过程由杨力，张万蕾,宋奕宁，王雪操作完成，数据分析及论文撰写由杨力完成;实验指导及论文修改由李建国完成。通讯作者：杨力，100044,北京市西城区西直门南大街11号，北京大学人民医院超声
2、科，yanglit@yahoo.com.cn电话010-88325380UltrasonicdiagnosisofacuteappendicitiswithatypicalclinicalmanifestationsLiYang,Wan-LeiZhang,Yi-NingSong,XueWang,Jian-GuoLiLiYang,Wan-LeiZhang,Yi-NingSong,XueWang,Jian-GuoLiDepartmentofultrasound,PekingUniversityPeop
3、lesHospital,Beijing100044,ChirmCorrespondenceto:Dr.LiYang,Departmentofultrasound,PekingUniversityPeoplesHospital,Beijing100044,Chinayanglit@yahoo.com.cnAbstractAIM:Toexplorethevalueofhighand1owfrequencyultrasoundinthediagnosisofacuteappendicitiswithat
4、ypicalclinicalmanifestations.METHODS:Atotalof65acuteappendicitispatientswithatypicalclinicalsymptomsandsignsbutconfirmedbysurgeryandpathologywereexaminedanddiagnosedbyhighfrequencyassociatedwithlowfrequencyultrasound.Theirultrasonicimagesofacuteappend
5、icitiswerereviewedretrospectively.RESULTS54patientswerediagnosedbyultrasound(83.01%,54/65).42swe11ingappendixwerefoundbylowfrequencyand54byhighfrequencyultrasound.Thefindingofappendixbyhighfrequencywashigherthanlowfrequencyultrasound(%2=4.32,/K0.05).S
6、omeindircctcvidcnccwereachievedbyultrasonography.Appendicealfecalithwasobservedin33patients(61.11%),localadynamicileusin25patients(46.29%),periappendicularfluidin21patients(38.88%)andcomplexmassin14patients(25.92%).Mesentericlymphadenectasiswerefoundi
7、n10patients(18.52%).CONCLUSIONInmostcases,thecorrectdiagnosisofacuteappendicitiswithatypicalclinicalmanifestationscouldbemadebyhighfrequencyassociatedwithlowfrequencyultrasound.KeyWords:AcuteAppendicitis,atypicalclinicalmanifestations,UItrasonography摘
8、要目的：探讨低频超声结合高频超声检查在临床不典型阑尾炎诊断中的应用价值方法：选择症状体征不典型，临床诊断腹病待查患者，分别使用3.5〜4.0MHz普通腹部探头和7.0〜10.0MHz高频探头做超声检查，经手术后病理证实为急性阑尾炎65例，结合具临床特征分析非典型急性阑尾炎超声声像图表现。结果65例患者超声诊断急性阑尾炎54例(83.01%,54/65),低频超声显示肿大阑尾40例(61.53%),高频超声显示肿大阑尾54例(83.01%),二者差异有统计学意义(咒2=4.32,Pv
