【正文】 left Xiece supine maintain bladder filling and auxiliary routine inspection of the kidneys and ureters, female patients to be checked on the bladder, uterus, accessories, has been excluded urological, gynecological system disease factors, male patients with bladder, prostate All genitourinary examination related disease has been ruled out factors specified the pain of patients with a do focus on checking with partial pressure check, the probe flat right lower quadrant appendectomy pressure on both ends of the probe slowly pushed the surrounding tissue, abdominal and retroperitoneal lumbar major muscle, iliac artery, vein between the inflamed appendix can be seen with the cecum continuation. a.acute appendicitis with perforation of the three cases, the ultrasound showed the coarse appendectomy swelling, bowel wall thickening, the level is not clear, serosal echo slightly stronger, heterogeneous internal echo, hypoechoic intimal surface of the mucosa and submucosa strong Echo continuous interrupt to consider Perforated appendix after confined by surgery. Dacute appendicitis with abscess four cases of acute appendicitis with abscess is acute appendicitis suppurative gangrene, omental adhesions moved to the right lower quadrant wrapped inflammatory mass, the positive rate of %. above cases ultrasound showed: inflammatory mass in the lower right abdomen exploration and hypoechoic irregular echo area, appendectomy morphology unclear, heterogeneous internal echo, hypoechoic or cysticsolid mixed mass, the boundary is not clear, its normal appendix longer pan, abscess formation, internal liquefaction obvious sound through the poor, breathing activity disappeared, suspected appendiceal abscess after confirmed by surgery.s white blood cell count and neutrophil percentage increased, but the increase was not obvious nor deny the diagnosis. noninvasive, no side effects, easy and quick, can repeat the advantages of dynamic observation by exploratory appendectomy size and shape, internal echo and mobility bined with clinical data to make more accurate ultrasound diagnosis of appendicitis, clinical diagnosis rate the B super play an important role in the differential diagnosis of acute appendicitis and other acute abdomen but in some cases there are also false negative, so it should be bined with a detailed medical history, a prehensive physical examination and laboratory tests, in order to make the right patients diagnosis so that patients receive timely treatment[3].s Medical Publishing House, 2011,2, Qian Yun Qiu, Zhou Xiaodong, Zhang Jun, editor the practical ultrasonic diagnostic manual (second edition) Amendment, the People39。3, Wang Zhibin main translation abdominal ultrasound diagnostic , People39。急性闌尾炎的超聲診斷摘　要：目的：探討超聲診斷對常見闌尾炎進(jìn)行的病例確定，進(jìn)一步提高超聲診斷作對闌尾炎確診的符合率。結(jié)果：超聲診斷各型闌尾炎特征明顯。關(guān)鍵詞：急性闌尾炎 超聲診斷 診斷標(biāo)準(zhǔn) 　　　　　　　急性闌尾炎的診斷通常主要依靠臨床經(jīng)驗(yàn)，傳統(tǒng)的影像技術(shù)，如X線等對臨床診斷急性闌尾炎效果不大，不容易明確診斷急性闌尾炎。尤其是采用了高頻探頭技術(shù)，更能利用闌尾炎的聲像特點(diǎn)，準(zhǔn)確無誤的對闌尾炎進(jìn)行診斷。　　 我院自2009年7月至2011年7月，經(jīng)超聲診斷檢出急性闌尾炎85例，所有病例均經(jīng)臨床確診或手術(shù)證實(shí)，并得到了及時的治療。　　 急性闌尾炎85例，年齡7~58歲，急性單純性闌尾炎58例，急性化膿性闌尾炎20例，急性闌尾炎伴穿孔3例，急性闌尾炎伴膿腫4例?！　?　　儀器采用德國西門子G60S彩色多普勒超聲診斷儀，比較瘦的人結(jié)合采用7~10MHZ高頻探頭。對患者指定的疼痛出做重點(diǎn)檢查，用局部加壓檢查法，將探頭平放右下腹闌尾區(qū)，于探頭兩端緩緩加壓將周圍的組織推開，在腹壁與腹膜后的腰大肌，髂內(nèi)動、靜脈之間，可見到發(fā)炎的闌尾與盲腸相延續(xù)?！　. 急性單純性闌尾炎58例，患者多表現(xiàn)為發(fā)病時間短，一般在1236小時之間，超聲表現(xiàn)為闌尾呈管狀結(jié)構(gòu)，輕度腫脹，呈蚯蚓狀，邊界模糊、壁增厚呈雙邊影，內(nèi)部呈低而均勻或欠均勻的回聲，漿膜回聲不光滑，管壁層次欠清晰。急性化膿性闌尾炎超聲表現(xiàn)為闌尾腫脹粗大，長軸似手指狀，末端鈍圓，腸壁增厚，層次不清晰，漿膜回聲稍強(qiáng)，尚光整，內(nèi)部回聲不均勻，呈低回聲，腔內(nèi)呈強(qiáng)回聲，闌尾腔及周圍滲出液增多，縱切呈臘腸狀，闌尾壁厚薄不一，橫切面呈強(qiáng)弱相間的環(huán)形回聲，呼吸時闌尾隨盲腸上下移動?！　。毙躁@尾炎伴膿腫是因急性闌尾炎化膿壞疽時，大網(wǎng)膜移至右下腹包裹粘連而形成的炎性腫塊，%?！　?討論但如果位置變異，同時受到鎮(zhèn)靜劑等的影響時，診斷就變得困難。實(shí)時超聲檢查具有無痛苦、無創(chuàng)傷、無副作用、簡便迅速，能重復(fù)動態(tài)觀察等優(yōu)點(diǎn)，通過探查闌尾的大小形態(tài)，內(nèi)部回聲和移動度等再結(jié)合臨床資料能夠?qū)﹃@尾炎做出較為正確的超聲診斷，提高了臨床確診率，使B超在急性闌尾炎和其他急腹癥鑒別診斷中具有重要作用。參考文獻(xiàn) 郭萬學(xué)主編《超聲醫(yī)學(xué)》(第六版) ，人民軍醫(yī)出版社，2011. 錢蘊(yùn)秋、周曉東、張軍主編《實(shí)用超聲診斷手冊》(第二版)修訂， 人民軍醫(yī)出版社， 2011. 王志斌主譯《腹部超聲診斷》，人民衛(wèi)生出版社，2005 . 學(xué)習(xí)好幫手科研文獻(xiàn)閱讀與科技論文寫作 班級：14級碩士行政2班 姓名：黃文輝 學(xué)號：201430130079 專業(yè)：中醫(yī)內(nèi)科學(xué) 寧可累死在路上，也不能閑死在家里！寧可去碰壁，也不能面壁。什么是奮斗？奮斗就是每天很難，可一年一年卻越來越容易。能干的人，不在情緒上計較，只在做事上認(rèn)真；無能的人！不在做事上認(rèn)真，只在情緒