小儿难复性肠套叠临床与MDCT的表现特征  

Clinical and MDCT features of pediatricirreducible intussusception

作　　者：关文华[1] 韩焱[2] 

机构地区：[1]河南科技大学第一附属医院分子影像中心,河南省洛阳市471003 [2]河南科技大学第一附属医院影像科,河南省洛阳市471003

出　　处：《实用医学杂志》2017年第9期1438-1441,共4页The Journal of Practical Medicine

基　　金：河南省卫生科技创新型人才工程(2010~2020年)专项经费资助项目(编号:04205)

摘　　要：目的:探讨小儿难复性肠套叠的临床和多排螺旋CT(MDCT)表现特征。方法:对19例难复性肠套叠和47例可复性肠套叠的临床与MDCT特征进行对比分析,包括年龄、病程、套叠体部长度(L)、套颈最大横径(D1)、套头最大横径(D2)、套头与套颈最大横径比值(D2/D1)与伴随影像征象。结果:(1)难复性肠套叠的病程、L和D2/D1值均大于对照组,而D1小于对照组,差异有统计学意义(P<0.05);病程、L和D2/D1值对应的曲线下面积(AUC)值均>0.7,临界值分别为33.0个月、7.5 cm和1.33。(2)难复性肠套叠多发生非回-结肠套的复杂性肠套叠(36.8%)、分别合并美克尔憩室(21.1%)、肠管坏死(21.1%)、阑尾炎(15.8%)、肠梗阻(10.5%)。结论:对于病程>33.0个月、L>7.5 cm、D2/D1>1.33的小儿肠套叠提示难复性肠套叠的可能,并应观察有无合并美克尔憩室、肠管坏死、阑尾炎和肠梗阻的存在。Objective To explore the clinical and MDCT features of pediatric irreducible intussusception. Methods 66 patients were divided into irreducible intussusception group （19 cases） and reducible intussusception group （47 cases）. Age clinical courses, length of intussusception body （L）, neck max diameter （D1）, head max diameter （D2） andthe ratio （D2/D1） and MDCT imaging data were compared and analyzed. Results （1） The course time, L and D2/D1 values of irreducible intussusception group were significantly higher than those of reducible group, the D1 was lower than that ofreducible group, and the difference is statistically significant （P 〈 0.05）. Clinical course,L and D2/D1 value AUC values were more than 0.7, the threshold values were 33.0 h, 7.5 cm and 1.33. （2） The occurrence rate of non-ileum-colon intussusception, Meekel＇s diverticulum, appendicitis and intestinal necrotic for irreducible intussusception were 36.8%, 21.1%, 21.1%, 15.8% and 10.5% respectively. Conclusion Whenthe time of course 〉 33.0 mo, D2/D1 〉 1.33 and L〉7.5 era, the irreducible intussuseeptioneould be considered, and Meekel＇s diverticulum, intestinal necrosis, appendicitis and intestinal obstruction should be judged further.

关 键 词：难复性肠套叠 儿童 体层摄影术 X线计算机 

分 类 号：R725.7[医药卫生—儿科] R816.92[医药卫生—临床医学]