先天性肥厚性幽门狭窄超声诊断标准的探讨  

The discussion of ultrasound in diagnosing congenital hypertrophic pyloric stenosis

作　　者：方建强 朱文峰 徐莉 张佳 茹彤 

机构地区：[1]陕西省咸阳市中心医院超声科,陕西咸阳712000

出　　处：《胃肠病学和肝病学杂志》2015年第3期278-280,共3页Chinese Journal of Gastroenterology and Hepatology

摘　　要：目的探讨先天性肥厚性幽门狭窄(congenital hypertrophic pyloric stenosis,CHPS)的超声诊断标准。方法采用小凸阵探头检查20例正常婴幼儿及20例CHPS患儿的胃体及幽门管图像,并测量幽门管长度、直径、幽门管肌层厚度及胃体部肌层厚度,动态观察胃壁蠕动和胃排空情况,并与手术结果对照。结果正常胃体部与正常幽门管肌层厚度相比,差异无统计学意义(P>0.05),CHPS胃体部与正常胃体部肌层厚度相比,差异无统计学意义(P>0.05);CHPS幽门管与正常幽门管肌层厚度相比,差异有显著统计学意义(P<0.01),CHPS幽门管与CHPS胃体部肌层厚度比较差异具有显著统计学意义(P<0.01)。超声显示20例CHPS患儿幽门管管壁蠕动消失,肌层明显增厚,幽门管腔狭窄,胃内容物不易通过幽门管腔,动态观察"宫颈征"不消失。结论CHPS超声诊断应以幽门管的"宫颈征"图像及动态观察中幽门管蠕动消失、"宫颈征"不消失为重要诊断依据,而幽门管的超声测量值作为辅助参考。Objective To investigate the ultrasonic diagnosis standards of congenital hypertrophic pyloric stenosis （CHPS）. Methods Small convex array probe was adopted to check the stomach and pyloric pipe images of 20 normal infants and 20 children with CHPS, the length and diameter of pyloric pipe, thickness of pyloric pipe＇ s muscular layer and gastric muscle thickness were measured, gastric peristalsis and gastric emptying were compared with surgical find- ings. Results The thickness of normal gastric body had no statistically significant difference from the thickness of nor- mal pyloric pipe muscular layer （P 〉 0.05） ; the thickness of CHPS gastric body had no statistically significant differ- ence from the thickness of normal gastric muscle （P 〉 0.05） ; CHPS pyloric pipe has obvious significance from pyloric pipe in muscle thickness （P 〈0.01） ; CHPS pyloric pipe had a very significant difference from CHPS gastric muscular thickness （P 〈 0.01 ）. Ultrasound indicated that the pyloric pipe tube wall peristalsis of 20 children with CHPS disap- pears, muscular layer was thickened, pyloric stenosis, it was not easy for gastric contents to go through the pyloric pipe, ＂cervix sign＂ did not disappear. Conclusion CHPS ultrasound diagnosis should take the ＂cervix sign＂ image and dis- appearance of pyloric pipe peristalsis in dynamic observation, and existence of ＂cervical syndrome＂ as important bases for diagnosis, and ultrasound measurements of pyloric pipe were used as auxiliary reference.

关 键 词：超声 先天性肥厚性幽门狭窄 婴幼儿 

分 类 号：R573.6[医药卫生—消化系统]