• 1. 四川大學(xué)華西醫(yī)院影像科（成都 610041） 2. 四川大學(xué)華西醫(yī)院老年病科（成都 610041）;

目的 　針對急診收治的一例疑似小腸梗阻（SBO）患者，檢索當(dāng)前最佳證據(jù)，為臨床合理診斷提供依據(jù)。
方法 　計算機(jī)檢索MEDLINE/PubMed（1978~2006.4）、SUMsearch（1978~2006.4）、CNKI（1978~2006.4），查找有關(guān)計算機(jī)體層攝影術(shù)（CT）診斷小腸梗阻的系統(tǒng)評價、橫斷面研究等，并對所獲證據(jù)進(jìn)行評價。
結(jié)果 　臨床證據(jù)表明，與參考標(biāo)準(zhǔn)小腸造影及外科手術(shù)診斷相比較，CT診斷小腸梗阻的敏感度和特異度均較高，并能在早期明確梗阻的類型及病因，提高臨床醫(yī)師正確處理小腸梗阻的能力。據(jù)此臨床證據(jù)，結(jié)合患者意愿，對患者進(jìn)行CT檢查，CT結(jié)果提示絞窄性小腸梗阻，需立即進(jìn)行手術(shù)治療。
結(jié)論 　CT是診斷小腸梗阻敏感性及特異性均較高的影像學(xué)檢查方法。

引用本文： 李崢艷,伍兵,張凌,吳紅梅. 一例疑似小腸梗阻患者的循證CT診斷. 中國循證醫(yī)學(xué)雜志, 2007, 07(4): 311-315. doi: 復(fù)制

1. GAO YT, MING B, LI ZX, et al. The Value of CT in the Diagnosis and Management of Patients with Acute Small-Bowel Obstruction. J Pract Radiol, 2004, 20(4): 78-79.
2. Shrake PD, Rex DK, Lappas JC, et al. Radiographic evaluation of suspected small bowel obstruction. Am J Gastroenterol, 1991, 86(16): 175-178.
3. Guyatt GH, Rennie D, Editors, The Evidence-Based Medicine Working Group. Users, Guides to the Medical Literature: A Mannual for Evidence-Based Clinical Practice. Chicago: AMA Press. 2002.
4. Phillips B, Ball C, Sackett D, et al. Levels of evidence and grades of recommendation. Available for URL:http://www.cebm.net.
5. Mallo RD, Salem L, Lalani T, et al. Computed tomography diagnosis of ischemia and complete obstruction in small bowel obstruction: a systematic review. J Gastrointest Surg, 2005, 9(24): 690-694.
6. Megibow AJ, Balthazar EJ, Cho KC, et al. Bowel obstruction: evaluation with CT. Radiology, 1991, 180(160): 313-318.
7. Fukuya T, Hawes DR, Lu CC, et al. CT diagnosis of small-bowel obstruction: efficacy in 60 patients. AJR Am J Roentgenol, 1992, 158(278): 765-769; discussion 771-772.
8. Maglinte DD, Gage SN, Harmon BH, et al. Obstruction of the small intestine: accuracy and role of CT in diagnosis. Radiology, 1993, 188(322): 61-64.
9. Frager D, Medwid SW, Baer JW, et al. CT of small-bowel obstruction: value in establishing the diagnosis and determining the degree and cause. AJR Am J Roentgenol, 1994, 162(169): 37-41.
10. Taourel PG, Fabre JM, Pradel JA, et al. Value of CT in the diagnosis and management of patients with suspected acute small-bowel obstruction. AJR Am J Roentgenol, 1995, 165(420): 1187-1192.
11. Maglinte DD, Reyes BL, Harmon BH, et al. Reliability and role of plain film radiography and CT in the diagnosis of small-bowel obstruction. AJR Am J Roentgenol, 1996, 167(538): 1451-1455.
12. Makanjuola D. Computed tomography compared with small bowel enema in clinically equivocal intestinal obstruction. Clin Radiol, 1998,53(69): 203-208.
13. Daneshmand S, Hedley CG, Stain SC. The utility and reliability of computed tomography scan in the diagnosis of small bowel obstruction. Am Surg, 1999, 65(78): 922-926.
14. Obuz F, Terzi C, Sokmen S, et al. The efficacy of helical CT in the diagnosis of small bowel obstruction. Eur J Radiol, 2003, 48(235): 299-304.
15. Jaffe TA, Martin LC, Thomas J, et al. Small-bowel obstruction: coronal reformations from isotropic voxels at 16-section multi-detector row CT. Radiology, 2006, 238(1239): 135-142.
16. 高源統(tǒng), 明兵, 李振勛, 等. CT在急性小腸梗阻病因診斷和處理中的價值，實用放射學(xué)雜志，2004, 20(4): 78-79.
  1. 1. GAO YT, MING B, LI ZX, et al. The Value of CT in the Diagnosis and Management of Patients with Acute Small-Bowel Obstruction. J Pract Radiol, 2004, 20(4): 78-79.
  2. 2. Shrake PD, Rex DK, Lappas JC, et al. Radiographic evaluation of suspected small bowel obstruction. Am J Gastroenterol, 1991, 86(16): 175-178.
  3. 3. Guyatt GH, Rennie D, Editors, The Evidence-Based Medicine Working Group. Users, Guides to the Medical Literature: A Mannual for Evidence-Based Clinical Practice. Chicago: AMA Press. 2002.
  4. 4. Phillips B, Ball C, Sackett D, et al. Levels of evidence and grades of recommendation. Available for URL:http://www.cebm.net.
  5. 5. Mallo RD, Salem L, Lalani T, et al. Computed tomography diagnosis of ischemia and complete obstruction in small bowel obstruction: a systematic review. J Gastrointest Surg, 2005, 9(24): 690-694.
  6. 6. Megibow AJ, Balthazar EJ, Cho KC, et al. Bowel obstruction: evaluation with CT. Radiology, 1991, 180(160): 313-318.
  7. 7. Fukuya T, Hawes DR, Lu CC, et al. CT diagnosis of small-bowel obstruction: efficacy in 60 patients. AJR Am J Roentgenol, 1992, 158(278): 765-769; discussion 771-772.
  8. 8. Maglinte DD, Gage SN, Harmon BH, et al. Obstruction of the small intestine: accuracy and role of CT in diagnosis. Radiology, 1993, 188(322): 61-64.
  9. 9. Frager D, Medwid SW, Baer JW, et al. CT of small-bowel obstruction: value in establishing the diagnosis and determining the degree and cause. AJR Am J Roentgenol, 1994, 162(169): 37-41.
  10. 10. Taourel PG, Fabre JM, Pradel JA, et al. Value of CT in the diagnosis and management of patients with suspected acute small-bowel obstruction. AJR Am J Roentgenol, 1995, 165(420): 1187-1192.
  11. 11. Maglinte DD, Reyes BL, Harmon BH, et al. Reliability and role of plain film radiography and CT in the diagnosis of small-bowel obstruction. AJR Am J Roentgenol, 1996, 167(538): 1451-1455.
  12. 12. Makanjuola D. Computed tomography compared with small bowel enema in clinically equivocal intestinal obstruction. Clin Radiol, 1998,53(69): 203-208.
  13. 13. Daneshmand S, Hedley CG, Stain SC. The utility and reliability of computed tomography scan in the diagnosis of small bowel obstruction. Am Surg, 1999, 65(78): 922-926.
  14. 14. Obuz F, Terzi C, Sokmen S, et al. The efficacy of helical CT in the diagnosis of small bowel obstruction. Eur J Radiol, 2003, 48(235): 299-304.
  15. 15. Jaffe TA, Martin LC, Thomas J, et al. Small-bowel obstruction: coronal reformations from isotropic voxels at 16-section multi-detector row CT. Radiology, 2006, 238(1239): 135-142.
  16. 16. 高源統(tǒng), 明兵, 李振勛, 等. CT在急性小腸梗阻病因診斷和處理中的價值，實用放射學(xué)雜志，2004, 20(4): 78-79.