新生儿坏死性小肠结肠炎X线征象与临床相关性分析  

The Study of X-ray Findings and Clinical Correlation of Neonatal Necrotizing Enterocolitis

作　　者：朱晴 唐文伟[1] 顾海磊 陆小燕 田忠甫 ZHU Qing;TANG Wenwei;GU Hailei;LU Xiaoyan;TIAN Zhongfu(Department of Radiology,Women's Hospital of Nanjing Medical University(Nanjing Maternity and Child Health Care Hospital))

机构地区：[1]南京医科大学附属产科医院(南京市妇幼保健院)放射科

出　　处：《中国医学计算机成像杂志》2021年第4期336-340,共5页Chinese Computed Medical Imaging

摘　　要：目的:探讨新生儿坏死性小肠结肠炎(NEC)腹部X线征象与临床分期、转归的相关性。方法:收集139例NEC腹部X线平片、临床资料,比较Ⅱ期、Ⅲ期NEC腹部X线征象差异,分析NEC腹部X线征象与治疗方式的关系。结果:NECⅠ期21例,Ⅱ期106例,Ⅲ期12例;内科治愈或好转117例,外科手术22例。Ⅱ期NEC肠管扩张、门静脉积气、气腹阳性率均低于Ⅲ期,差异有统计学意义(P<0.05)。内科治疗组NEC肠管扩张、肠壁积气、门静脉积气、气腹阳性率均低于外科手术组,差异有统计学意义(P<0.05),logistic回归提示,肠管扩张(x_(1))、气腹(x_(4))与是否需要外科手术治疗关系最密切,拟合方程:y=2.354x_(1)+3.094x_(4)-6.187。结论:X线平片中肠管扩张、门静脉积气、气腹征象对NEC病情进展有提示作用,肠管扩张、气腹征象与外科手术选择关系最密切。Purpose:To investigate the correlation between abdominal X-ray signs and clinical stage and outcome of neonatal necrotizing enterocolitis(NEC).Methods:The plain abdominal radiography images and clinical data of the 139 cases of NEC were collected.The differences of abdominal X-ray signs of NEC between stageⅡand stageⅢwere analyzed.The relationship between abdominal X-ray signs and treatment methods of NEC was evaluated.Results:The patients were divided into three groups,including stageⅠ(n=21),stageⅡ(n=106)and stageⅢ(n=12).All patients were divided into internal medicine cure group(n=117)and surgical group(n=22).The positive rates of blind expansion,portal venous gas and pneumoperitoneum in stageⅡNEC were lower than those in stageⅢ,and the difference was with statistical significance(P<0.05).The positive rates of blind expansion,pneumatosis intestinalis,portal venous gas and pneumoperitoneum in internal medicine cure group were lower than those in surgical group,and the difference was with statistical significance(P<0.05).Surgical timing mostly corresponded to blind expansion and pneumoperitoneum of abdominal X-ray.The logistic regression equation was y=2.354 x_(1)+3.094 x_(4)-6.187(blind expansion:x_(1);pneumoperitoneum:x_(4)).Conclusion:The X-ray signs of blind expansion,portal venous gas and pneumoperitoneum were suggestive of the disease progression of NEC.The X-ray signs of blind expansion and pneumoperitoneum were most closely related to surgical options.

关 键 词：坏死性小肠结肠炎 腹部平片 Bell分期 手术治疗 

分 类 号：R445.4[医药卫生—影像医学与核医学]