实时超声灌肠充盈检查诊断小儿继发性肠套叠的临床价值  

The Clinical Value of Real-time Ultrasound-guided Saline Enema Examination in the Diagnosis of Secondary Intussusception in Children

作　　者：陆文明 沈艳 李金晶 Lu Wenming;Shen Yan;Li Jinjing(Department of Ultrasound, Huzhou The First People Hospital, Huzhou, Zhengjiang 313000, China)

机构地区：[1]浙江省湖州师范学院附属第一医院超声医学科,浙江省湖州市313000

出　　处：《中国超声医学杂志》2018年第7期637-640,共4页Chinese Journal of Ultrasound in Medicine

摘　　要：目的探讨实时超声下生理盐水灌肠充盈检查诊断小儿继发性肠套叠的临床应用价值。方法收集我院采用超声常规检查和灌肠充盈检查诊断小儿继发性肠套叠47例的临床资料进行回顾总结,并与手术病理对照分析。结果 47例小儿继发性肠套叠病因病理:结肠幼年性息肉20例,梅克尔憩室8例,囊肿型肠重复畸形6例,紫癜性肠炎5例,回肠恶性淋巴瘤2例,回肠管状腺瘤、Peutz-Jeghers综合征回肠息肉、回盲瓣炎性息肉、回肠黏膜下迷走胰腺、回肠炎性肌纤维母细胞瘤、降结肠癌各1例。常规超声检查符合率68.09%(32/47);灌肠充盈检查符合率95.74%(45/47)。肠套叠部位:小肠15例,回盲部11例,结肠21例。肠套叠类型:回回型5例、回回结型10例、回盲型11例、结结型17例、结直肠型4例。结论超声灌肠充盈检查明显提高小儿继发性肠套叠病理性诱发点检出率、确定肠套叠部位和类型、大大减少临床剖腹手术探查率。另该法安全简便、无创伤痛苦及辐射,可替代CT、X线下空气灌肠检查,成为小儿继发性肠套叠首选检查方法。Objective To investigate the clinical value of real-time ultrasound-guided saline enema in diagnosing secondary intussusception in children.Methods The clinical data of 47 cases of secondary intussusception in children between,both examined by conventional ultrasound examination and ultrasound-guided saline enema examination,were retrospectively reviewed,analyzed and compared with the operation and pathology.Results The etiologies and pathologies of 47 cases of secondary intussusception in children were：20 cases of juvenile colonic polyps,8 cases of Merkel′s diverticulum,6 cases of cystic intestinal repeat malformation,5 cases of Henoch-Sch nlein purpura,2 cases of ileal lymphoma and 1 case of each of the followings：ileal tubular adenoma,ileal polyps caused by Peutz-Jeghers syndrome,ileocecal inflammatory polyps,ileal submucosal ectopic pancreas,ileal inflammatory myofibroblastictumor and descending colon cancer.The coincidence rate of conventional ultrasound examination and ultrasound-guided saline enema examination were68.09%（32/47）and 95.74%（45/47）,respectively.The locations of intussusception were：15 cases in small intestine,11 cases at ileocecal valve and 21 cases in colon.The types of intussusception were：5 cases of ileo ileal intussusception,10 cases of ileo-ileo-colicintussusception,11 cases of ileocecal intussusception,17 cases of colocolicintussusception,4 cases of colorectalintussusception.Conclusions The ultrasound-guided saline enema examinationsignificantly improves the detection rate of the pathological inducing factors of secondary intussusception in children,determines the locations and types of intussusception and reduces the rate of laparotomy exploration.Moreover,this method is safe,convenient,painless and radiation-free,which can replace CT,X-ray air enema examination and become the preferred examination approach for secondary intussusception in children.

关 键 词：超声 灌肠检查 肠套叠 继发性 小儿 

分 类 号：R445.1[医药卫生—影像医学与核医学] R725.7[医药卫生—诊断学]