超声下空气灌肠整复小儿肠套叠的应用价值  

Value of sonographic guidance of air enema for pediatric intussusception reduction

作　　者：孙博[1,2,3] 田军[1] 班永光[1] 徐重阳[4] 张殿星[1] 王丹[5] 王刚[1] 亓恒涛[1] 焦晨伟 

机构地区：[1]山东大学附属山东省医学影像学研究所,山东济南250021 [2]山东医学影像新技术应用重点实验室,山东济南250021 [3]山东大学断层影像解剖学研究中心,山东济南250012 [4]济南市槐荫人民医院,山东济南250021 [5]山东大学附属山东省立医院,山东济南250021

出　　处：《医学影像学杂志》2016年第10期1825-1828,共4页Journal of Medical Imaging

基　　金：山东省科技发展计划项目(编号2014GSF118137);济南市临床医学科技创新计划(编号201503026);山东省自然科学基金青年基金(编号ZR2013HQ013)

摘　　要：目的 探讨超声下空气灌肠整复术治疗小儿肠套叠的临床应用价值。方法 回顾分析本院37例超声引导下空气灌肠整复小儿肠套叠的影像学资料。所有患儿均先行立位腹透排除膈下游离气体,再行常规超声检查,明确诊断后,直接在超声实时监视下,采用空气灌肠机对患儿进行空气灌肠,整复压力为6～12k Pa。如套头出现停顿不动,则排气后对相应部位的腹部进行揉按。再继续充气并用超声观察,如发现套头迅速消失且大量气体进入小肠,小肠区内见广泛气体强回声,则提示整复成功。结果 本组肠套叠患儿均为回—结肠型,横切面上均表现为典型的“同心圆征”,所有患儿均成功整复。其中3例患儿整复后出现回盲瓣处水肿,在声像图上可见环形低回声的水肿带,称为“暗环征”。结论超声下空气灌肠整复小儿肠套叠既方便、快捷,又避免了常规X线透视的辐射损害,有望成为小儿肠套叠的首选治疗方法。Objective To investigate the clinical value of sonographic guidance of air enema for pediatric intussusception reduction. Methods We retrospectively analyzed imaging data of 37 children with acute intussusception. All patients were performed abdominal radiography before the air enema to eliminate the possible presence of free abdominal gas. After sonographic diagnosis confirmed, all the patients directly underwent sonographic guidance of air enema for reduction. The enema pressure was set from 5 kPa to 12 kPa. If a complicated perforation occurred, soft chirismus was performed on the belly. The enema reduction would be performed successfully if the intussusception section disappeared quickly and lots of air run into the small bowel. Results All cases were ilium-colon type with typical ＂concentric tings sign＂, and were redueted successfully by air enema. Edema of ileocecal valve, which manifested as hypoechoic annular zone and were called as ＂dark ring sign＂, were found in 3 cases. Conclusion Sonographic guidance of air enema for intussusception reduction is a convenient, quick and none-radiative method for the treatment of intussusception. It may be expected to become the preferred treatment in the future.

关 键 词：超声诊断 空气灌肠整复 肠套叠 小儿 

分 类 号：R574[医药卫生—消化系统] R814[医药卫生—内科学]