不同年龄婴儿肥厚性幽门狭窄超声诊断界值的探讨  

Infantile hypertrophic pyloric stenosis:investigation of different ultrasonographic diagnostic criteria applied to infants

作　　者：王峥嵘[1] 刘琴[1] 苏英姿[1] 张丽娥[1] 张薇薇[1] 任红雁[1] 张勇[1] 李贺云 

机构地区：[1]首都儿科研究所附属儿童医院超声科,北京市100020

出　　处：《临床超声医学杂志》2016年第2期100-103,共4页Journal of Clinical Ultrasound in Medicine

摘　　要：目的探讨不同年龄婴儿肥厚性幽门狭窄(IHPS)的超声诊断界值。方法选取637例临床高度怀疑IHPS而行超声检查的患儿,按年龄分为≤21 d组(93例)和≥22 d组(544例),对比分析超声检查结果和手术或上消化道造影结果;将IHPS患儿的幽门肌层厚度(PMT)、幽门管长径(PCL)与年龄进行Pearson相关性分析;比较两组IHPS患儿PMT和PCL均值,以确定PMT最佳诊断界值。结果以PMT≥4.0 mm,PCL≥16.0 mm为标准,超声诊断两组IHPS患儿的敏感性分别为68%和98%;特异性均为100%。两组IHPS患儿PMT均值比较差异有统计学意义(P<0.01)。在≤21 d组中,PMT的最佳诊断界值为3.4 mm,其超声诊断IHPS的敏感性、特异性分别为95%、100%。结论不同年龄患儿建议采用不同的IHPS超声诊断界值:≤21 d患儿为PMT≥3.4 mm,PCL≥16.0 mm;≥22 d患儿为PMT≥4.0 mm,PCL≥16.0 mm。Objective To investigate different ultrasonographic criteria for infantile hypertrophic pyloric stenosis （IHPS）applied to infants. Methods A total of 637 infants suspected with IHPS were evaluated with uhrasonography, They were divided into ≤21 d of age group（9$ cases） and ≥ 22 d of age group（544 cases）. The ultrasonic fingdings of these infants were compared with the results of the operation or the upper gastrointestinal contrast study. Pearson correlation was used to analyze the correlation between pyloric muscle thickness （PMT）, pyloric channel length （PCL） and age in infants with IHPS. PMT and PCL were compared between the two groups respectively in order to define the cutoff values of PMT for IHPS. Results Using the diagnostic criteria of PMT ≥4.0 mm and PCL ≥ 16.0 ram,the sensitivity of ultrasound in diagnosis of two groups were 68% and respectively, and the specificity were both 100%. There was significant difference of PMT between the two groups（P〈0.01 ）. In ≤ 21 d of age group,using 3.4 mm as efficient cutoff values for PMT,the sensitivity and specificity of US for IHPS were 95% and 100%, respectively. Conclusion Different ultrasonographic diagnostic criteria for IHPS should be applied to infants at different ages. In infants at 22 d or older, the ultrasonographic diagnostic criteria of PMT ≥ 4.0 mm and PCL ≥ 16.0 mm remains efficient for IHPS, in infants at 21 d or younger, the uhrasonographic diagnostic criteria of PMT ≥ 3.4 mm and PCL ≥16.0 mm is considered efficient for IHPS.

关 键 词：超声检查 诊断界值 肥厚性幽门狭窄 婴儿 

分 类 号：R725.7[医药卫生—儿科] R445.1[医药卫生—临床医学]