新生儿坏死性小肠结肠炎的X线征象和临床因素分析  

The study of X-ray findings and clinical factors of neonatal necrotizing enterocolitis

作　　者：李涛[1] 张增俊[2] 杨军乐[3] 

机构地区：[1]西安市第一医院,陕西西安710002 [2]西安市儿童医院 [3]西安市中心医院

出　　处：《实用放射学杂志》2015年第9期1503-1505,1514,共4页Journal of Practical Radiology

摘　　要：目的：分析新生儿坏死性小肠结肠炎（NEC）的 X 线征象及临床因素,提高对新生儿 NEC 的认识。方法回顾性分析经临床及手术确诊的21例新生儿 NEC 患者的腹部 X 线平片、临床资料及危险因素。结果NEC 的 X 线表现：Ⅰ期,肠动力性改变,肠间隙增厚≤2 mm 者10例；Ⅱ期,①肠间隙增厚〉2 mm（4例）；②肠壁积气（4例）；③门静脉积气（3例）；Ⅲ期,①明确腹腔渗液（3例）；②气腹（3例）。早产儿18例（85%）；低体重儿16例；新生儿呼吸窘迫综合征、感染、肺炎、败血症和机械通气是 NEC 重要的危险因素。结论新生儿 NEC 的 X 线征象早期缺乏特征性,中晚期具有特征性表现,明确诊断需结合临床表现及致病危险因素,必要时动态随观。Objective To study the X-ray findings and clinical factors of the neonatal necrotizing enterocolitis （NEC）and to im-prove the detection rate of neonatal NEC-especially early lesions.Methods To retrospectively analyzed the plain abdominal radio-graphy images and clinical data of the 21 cases with confirmed neonatal NEC by clinical and surgical diagnosis.Results The X-ray findings of neonatal NEC：stageⅠ：10 cases showed the changes in intestinal motility and the interval thickness between the intestine≤2 mm;stageⅡ：① 4 cases showed the interval thickness between the intestine 〉 2 mm;② 4 cases showed the pneumatosis of the intestinal wall;③ the pneumatosis of the portal vein were three cases;stage Ⅲ：① 3 cases showed seroperitoneum;② pneumoper-itoneum were three cases.18 cases （85%）were the premature infan;1 6 of 21 cases NEC were the low birth weight;neonatal respiratory distress syndrome,infection,pneumonia,sepsis,and mechanical ventilation therapy are important risk factors of NEC. Conclusion X-ray findings has characteristic signs in the neonatal NEC.At the early of NEC,it is very important to make the correct diagnosis need combine X-ray performance with the clinical manifestations and risk factors for,with the necessary dynamic follow-up review in the clinical treatment and prognosis.

关 键 词：新生儿 坏死性小肠结肠炎 X线摄影术 

分 类 号：R574.4[医药卫生—消化系统] R814.41[医药卫生—内科学]