超声助显剂灌肠与X线钡灌肠在先天性巨结肠诊断中的应用价值  

Ultrasound-assisted enema plus X-ray barium enema for diagnosing Hirschsprung's disease:a retrospective study

作　　者：虞梅[1] 葛郁荣 石静[2] 陆玉洁 Yu Mei;Ge Yurong;Shi Jing;Lu Yujie(Department of Pediatric Surgery,Municipal Women&Children's Healthcare Center,Guiyang 550002,China;Department of Ultrasonic Medicine,Municipal Women&Children's Healthcare Center,Guiyang 550002,China)

机构地区：[1]贵阳市妇幼保健院儿外科,贵州省贵阳市550002 [2]贵阳市妇幼保健院超声医学科,贵州省贵阳市550002

出　　处：《临床小儿外科杂志》2021年第3期236-240,共5页Journal of Clinical Pediatric Surgery

基　　金：贵阳市卫生和计划生育委员会科学技术计划项目(编号:[2018]筑卫计科技合同字第015号)。

摘　　要：目的探讨超声助显剂灌肠与X线钡灌肠在先天性巨结肠诊断中的应用价值。方法以贵阳市妇幼保健院39例经直肠黏膜活检及手术病理确诊的先天性巨结肠患者为研究对象,同时行超声助显剂灌肠以及X线钡灌肠检查,对诊断结果进行对比分析。结果超声助显剂灌肠诊断先天性巨结肠阳性36例,真阳性率为92.3%(36/39)。根据狭窄痉挛段累及范围分型:常见型19例,短段型6例,超短型4例,长段型4例,全结肠型3例,漏诊3例。X线钡灌肠诊断先天性巨结肠阳性35例,真阳性率为89.7%(35/39),其中常见型18例,短段型5例,超短型3例,长段型4例,全结肠型5例,漏诊4例。超声助显剂灌肠以及X线钡灌肠检查诊断结果差异无统计学意义(P>0.05);两者联合诊断先天性巨结肠38例,诊断真阳性率为97.4%(38/39),其中常见型19例,短段型6例,超短型4例,长段型4例,全结肠型5例,漏诊1例。与单用一种检查方法相比,联合诊断真阳性率更高(P<0.05)。结论超声助显剂灌肠与X线钡灌肠在先天性巨结肠的诊断中均可提供较为可靠的影像学依据,二者均可作为常规无创检查手段。Objective To explore the application value of ultrasound-assisted enema plus X-ray barium enema in the diagnosis of Hirschsprung's disease in children.Methods Retrospective reviews were performed for 39 cases of congenital megacolon confirmed by rectal mucosal biopsy and surgery.Meanwhile,comparative analysis was made for the results of ultrasound assisted enema,X-ray barium enema,rectal mucosal biopsy and pathology.Results According to the scope of involvement of stenosis and spasm segment,the clinical types were common(n=19),short segment(n=6),ultra-short segment(n=4),long segment(n=4),total colonic(n=3)and missed diagnosis(n=3).Thirty-five cases of congenital megacolon were diagnosed by X-ray barium enema with a diagnostic coincidence rate of(89.7%,35/39).The clinical types were common(n=18),short segment(n=5),ultra-short segment(n=3),long segment(n=4),total colonic(n=5)and missed diagnosis(n=4).And the difference was not statistically significant.Thirty-eight cases of congenital megacolon were diagnosed by combining two methods with a diagnostic coincidence rate of(97.4%,38/39).The clinical types were common(n=19),short segment(n=6),ultra-short segment(n=4),long segment(n=4)and total colonic(n=5).Significant difference existed in detection rate between combining two methods and one single method(P<0.05).Conclusion The coincidence rate of ultrasonography-assisted enema and barium X-ray enema is high in children with congenital megacolon.It provides reliable imaging evidence for early clinical diagnosis and early surgery.Both methods are routine and non-invasive.

关 键 词：先天性巨结肠/诊断 超声检查 放射摄影术 病理学 外科 

分 类 号：R726.1[医药卫生—儿科] R574[医药卫生—临床医学]