目的 探讨多层螺旋CT诊断方法 在急诊老年血管源性急腹症中特征及其临 床研究意义。方法 回顾性分析了2014年2 月至2015年1月在我院急诊科就诊的急腹 症老年患者，选取同时行超声和多层螺旋 CT两项检查且临床确诊为血管源性急腹 症的患者36例。比较两种诊断方法的准确 性。结果 超声诊断腹主动脉瘤5例，动脉 夹层8例，肠系膜上静脉血栓1例，肠系膜 上动脉血栓2例，肾动脉主干及分支栓塞 4例，门静脉栓塞3例，假性动脉瘤3例。 多层螺旋CT诊断腹主动脉瘤5例，动脉夹 层8例，肠系膜上静脉血栓2例，肠系膜上 动脉血栓3例，肠系膜扭曲5例，肾动脉主 干及分支栓塞4例，门静脉栓塞6例，假性 动脉瘤3例。超声的诊断准确率为72.2%； 螺旋CT的诊断准确率为100%；经统计学比 较，两种诊断方法的准确率有显著差异 (χ2 =11.61，P＜0.01)。结论 多层螺旋 CT诊断方法在急诊老年血管源性急腹症中 具有较好的成像效果，对血管源性的病变 范围及情况的确定具有重要意义。

Objective To investigate the CT diagnosis method of spiral features and clinical significance on the elderly patients with vasogenic acute abdomen. Methods A retrospective analysis of February 2014 to January 2015 in our hospital emergency department emergency elderly patients with acute abdomen, select simultaneously both ultrasound and multi-slice spiral CT examination and a clinical diagnosis of acute abdomen bloodborne 36 patients. Compare the accuracy of two diagnostic methods. Results Ultrasound diagnosis of abdominal aortic aneurysm five cases, arterial dissection eight cases, one case of superior mesenteric vein thrombosis, arterial thrombosis of the superior mesenteric two cases, renal artery and its branches embolism four cases, three cases of portal vein thrombosis, pseudoaneurysm three cases. Multislice spiral CT diagnosis of abdominal aortic aneurysm five cases, arterial dissection eight cases, two cases of superior mesenteric vein thrombosis, arterial thrombosis of the superior mesenteric three cases, five cases of mesenteric twist, renal artery and its branches embolism four cases, six cases of portal vein thrombosis, pseudoaneurysm three cases.Ultrasound diagnostic accuracy rate of 72.2%. Spiral CT diagnostic accuracy was 100%, by statistical comparison of two diagnostic accuracy of the method was significantly different (χ2=11.61, P<0.01). Conclusion Spiral CT angiography diagnosis method has good effect in elderly emergency vascular acute abdomen, determining significance of the lesions and vascular conditions.