彩色多普勒超声检查在小儿肠套叠诊断和治疗中的作用  

High-frequency color Doppler in infant intussusception diagnosis and treatment

作　　者：魏达友[1] 刘思怡[1] 蔡永秋[1] 梁玉婷[1] 吴绍锋[1] 

机构地区：[1]茂名市人民医院超声科,广东省茂名525000

出　　处：《中国基层医药》2008年第2期289-291,I0004,共4页Chinese Journal of Primary Medicine and Pharmacy

摘　　要：目的探讨高频彩色多普勒超声检查对小儿肠套叠的诊断价值，并根据套叠肠管及其肠系膜血管的血流动力学情况选择复位治疗方式，进行疗效观察。方法对377例可疑肠套叠患儿进行高频彩色多普勒超声检查，确诊肠套叠后，重点观察套叠肠管及其肠系膜血管的血流动力学情况，并依此选择进行水压灌肠复位治疗。结果高频彩色多普勒超声确诊肠套叠263例，诊断符合率100％，其中选择水压灌肠复位成功253例，复位成功率96．2％；10例复位失败后改手术治疗，失败组套叠肠管肠壁严重水肿，无血流显示。结论高频彩色多普勒超声诊断小儿肠套叠准确率高。根据套叠肠管及其肠系膜血管的血流动力学情况可将肠套叠分三种类型：Ⅰ型即肠管肠壁血流信号增加或正常，应用水压灌肠复位；Ⅱ型即肠管肠壁血流较少且阻力指数偏高，尽量试用水压灌肠复位；Ⅲ型即肠壁严重水肿，阻力指数显著升高，无血流显示，禁忌水压灌肠复位，应尽快手术治疗。Objective To explore the application of high-frequency color Doppler in the diagnosis of infant intussusception and the selection of reduction mode according to the hemodynamic situations of intussusception intestine tube and blood vessel in mesentery. Methods A total of 377 cases of doubtful intussusception infants were checked by high-frequency color Doppler. After they had been diagnosed, the hemodynamic situations of intussuscepiton intestine tube and blood vessel in mesentery were carefully observed and the ultra-sound had 3 types and then the hydrostatic enema reduction was chosen as treatment method. Results A total of 263 cases was diagnosed by highfrequency color Doppler with rate of coincidence of 100%. Among them are 253 successful cases reduced by hydrostatic enema. The successful rate of reduction was 96.2 % and the 10 failed cases were changed to be treated by operation. The intestinal wall of intussusception tube in failure group had serious dropsy without blood flow shown. Conclusions It is accurate that the infant intussusception is diagnosed by high-frequency color Doppler. According to the hemodynamic situations of intussusceptin intestine tube and blood vessel in mesentery,the infant intussusception can be divided into 3 types as follows： type Ⅰ ：the blood signal of intestinal tube and wall is up or normal, which shall be reduced by hydrostatic enema;type Ⅱ ：the blood signal of intestinal tube and wall is small with high obstruction index, which shall be reduced by hydrostatic enema as possible as it can; type Ⅲ ：the intestinal wall has serious dropsy with rather high obstruction index and without blood flow shown, in which the hydrostatic enema reduction shall be banned and the operation shall be carried out as soon as possible.

关 键 词：肠套叠 超声检查 多普勒 彩色 

分 类 号：R72[医药卫生—儿科] R44[医药卫生—临床医学]