新生儿坏死性小肠结肠炎X线诊断  

X-ray Diagnosis on Necrotic Enterocolitis of Neonate

作　　者：李彦伟[1] 梁永强[1] 

机构地区：[1]广州市花都区胡忠医院CT室,广东广州510800

出　　处：《黑龙江医学》2006年第1期3-5,共3页Heilongjiang Medical Journal

摘　　要：目的探讨新生儿坏死性小肠结肠炎X线表现，加深对本病的进一步认识。方法收集我院1998—2005年经X线及临床确诊病例32例。均采用腹部仰卧前后位、立住摄片，必要时摄水平倒位片及多体位腹透方法诊断，对早期病变采用间隔12-24h追踪观察，观察其病变发展过程，指导临床及早采取相应的治疗措施。结果32例中，30例为早产儿，2例为未足周产儿，诊断早期表现仅5例，主要X线表现为不完全性小肠梗阻，肠间隙增宽、模糊，腹脂线不清，占16％。典型期表现21例，主要X线表现为胃／肠壁内局限性壁内积气，肠管积气扩张，排列紊乱，部分肠管固定，占66％。晚期表现6例，主要X线表现为胃肠壁内广泛散在积气及气腹影，占18％。32例病例中，伴门静脉积气2例，伴胃肠穿孔4例，除2例死亡外，其余30例经临床治疗病愈后出院。结论新生儿坏死性小肠结肠炎早期X绒表现不明显，容易误诊、漏诊，若临床怀疑有NEC表现，X线检查一定要全面细致，如侧卧水平位投照可观察到少量气腹影，及早诊断胃肠穿孔，指导临床及早采取手术治疗，对挽救患儿生命具有重要价值。Objective To discuss the X - ray appearance of necrotic enterocolitis （NEC） of neonate and improve the further recognition. Methods 32 cases of such patient who obtained the diagnosis with X - ray and clinic from 1998 to 2005 were analyzed, The A - P X - ray in supination and erect position was taken and lateral projection or inspectscope with X - ray were taken if necessary. The early lesion was taken monitor every 12 or 24 hours to observe the changes and indicate the relative treatment. Results There were 5 cases of 32 in early stage, 21 cases in typical and 6 cases in late stage when diagnosed. The early appearance was un - complete obstructive of small intestine, widen and obscure of its interspace, unclear of abdominal fat line. The typical appearance was local pneumatosis of intra - gastrointestinal wall and track dilated with disorder as some of them fixed. The late appearance was the extensive pneumatosis of intra - gastrointestinal wall and image of aeroperitoneum, There were male 22 and female l0 cases with average age of 4 days （ 12 h - 8 day）. There were 2 cases of pneumatosis of portal vein, 4 cases of perforation of digestive tract and 2 died. The other were cured. Conclusion The appearance of early stage might be unclear that easily lead to misdiagnosed. The detail and monitor of X - ray detection should be taken when the case is doubted NEC so that to indicate the further treatment procedure such as operation when needed to improve survival rate.

关 键 词：医学影像学 新生儿 新生儿坏死性结肠炎 

分 类 号：R445.1[医药卫生—影像医学与核医学]