腹部加压上消化道造影对新生儿肠旋转不良的诊断价值  

The Diagnostic Value of Upper Gastrointestinal Imaging with Manual Epigastric Compression in Intestinal Malrotation of Neonates

作　　者：陈桦[1] 何四平[1] 

机构地区：[1]湖南省儿童医院,湖南长沙410007

出　　处：《临床小儿外科杂志》2002年第5期344-346,F003,共4页Journal of Clinical Pediatric Surgery

摘　　要：目的探讨上腹部加压上消化道造影对新生儿肠旋转不良的诊断价值。方法22例新生儿于上消化道造影时行上腹部按摩加压。经胃管注入造影剂后,将手放于患儿上腹部近剑突下的十二指肠体表部位,向右边及下方轻轻推压,持续时间约30秒,对22例新生儿上消化道造影加压前、加压期间及加压后的X线表现进行回顾性分析。结果22例行加压上消化道造影时,均显示有十二指肠空肠交界处移至脊柱的右侧,停止加压后,十二指肠空肠交界处位置仍异常,14例表现为十二指肠近端扩张,经手法加压后,显示造影剂通过梗阻处的位置异常,2例伴有肠扭转。结论上腹部按摩加压技术简便安全,能清楚显示十二指肠的解剖结构,加压与松压后十二指肠空肠交界处位置持续异常的特征性X线表现,对新生儿肠旋转不良的诊断及鉴别诊断具有重要的价值。Objective To discuss the diagnosis value of manual epigastric compression during upper gastrointestinal imaging of intestinal malrotation in neonates.Methods 22neonates underwent manual compression during upper gastrointestinal examination.Contrast agent was administered through catheter placed in the stomach,compression was performed by applying gentle,steady rightward and downward pressure with the hand,which was placed on the epigastrium just below the xiphoid,over the area of duodenum,duration of compression was30sec.The X-ray findings were retrospectively reviewed for located in duodenojejunal junction before during,and after manual compression.Results In22cases,the duodenojejunal junction was displaced to the right of the spine with manual compression during upper gastrointestinal examination,after compression was discontinued,the duodenojejunal junction remained in an abnormal position,14patients showed proximal duodenal obstruction,when manual compression was appied,contrast material was forced past the obstruction,two cases showed volvulus.Conclusions Manual compression during upper gastrointestinal examination is safe and simple technique,the manual compression methods allows visualization of the anatomy of the duodenum,of a persistent abnormally position duodenjejunal junction after release of compression is an important feature,it can play an important role in diagnosis and differential diagnosis of malrotation in neonates.[

关 键 词：肠疾病 放射摄影术 放射摄影术 腹部 

分 类 号：R816.92[医药卫生—放射医学]