超声检查对婴幼儿胃食管返流的筛查价值  

Value of ultrasonography in screening gastroesophageal reflux in infants

作　　者：杨云飞 吕兴锟 侯跃会 李静 YANG Yun-fei;LV Xing-kun;HOU Yue-hui;LI Jing(Color Doppler Ultrasound Room,the Second Affiliated Hospital of Hebei College of Traditional Chinese Medicine,Dingzhou 073000,Hebei,China;Department of Spleen and Stomach Diseases,the Seventh People's Hospital of Hebei Province,the Second Affiliated Hospital of Hebei College of Traditional Chinese Medicine,Dingzhou 073000,Hebei,China)

机构地区：[1]河北中医学院附属第二医院•河北省第七人民医院彩超室,河北定州073000 [2]河北中医学院附属第二医院•河北省第七人民医院脾胃病科,河北定州073000

出　　处：《川北医学院学报》2022年第5期614-616,共3页Journal of North Sichuan Medical College

基　　金：河北省2020年度医学科学研究课题计划项目(20200622)。

摘　　要：目的:探讨超声检查对婴幼儿胃食管反流(GER)的诊断价值。方法:GER婴幼儿200例(GER组),同期健康体检婴幼儿50名(对照组),均行腹部超声检查;比较两组超声图像特征、胃贲门角(His角)、腹段食管长度,通过绘制受试者工作特征(ROC)曲线分析组His角、腹段食管长度诊断婴幼儿GER的临床价值。结果:GER组超声图像显示,食管管壁呈弱回声,腹段食管长度缩短,His角增大,管腔内可见少量彩色血流信号;对照组超声图像显示,食管壁及管腔呈“靶环征”,管壁呈结构清晰呈高回声,腹段食管长度正常,管腔内无血流信号。GER组His角大于对照组(P<0.05),腹段食管长度短于对照组(P<0.05)。His角、腹段食管长度及二者联合诊断GER的ROC曲线下面积(AUC)分别为0.899、0.719、0.915,灵敏度分别为93.00%、64.50%、90.00%,特异度分别为76.00%、72.00%、84.00%。结论:胃肠超声参数His角、腹段食管长度对鉴别婴幼儿GER有较高的价值,且两者联合的诊断价值高于单项指标,可作为婴幼儿GER辅助诊断手段之一。Objective:To investigate the diagnostic value of ultrasonography for gastroesophageal reflux(GER) in infants.Methods:A total of 200 infants with GER(GER group) and 50 healthy infants during the same period(control group) were selected and underwent abdominal ultrasound examination.The ultrasonic image features, gastric cardia angle(His angle) and abdominal esophageal length were compared between the two groups.The clinical value of His angle and abdominal esophageal length in the diagnosis of GER in infants was analyzed by drawing the receiver operating characteristic(ROC) curve.Results:The ultrasound images of GER group showed that the esophageal wall was weakly echoed, the length of the abdominal esophagus was shortened, the His angle was increased, and a small amount of color blood flow signals were visible in the lumen.The ultrasonic images of the control group showed that the esophageal wall and lumen showed “target ring sign”,and the wall showed clear structure and high echo, abdomen esophagus length was normal, no blood flow signal in the lumen.His angle in the GER group was significantly higher than that in the control group(P<0.05),and the length of abdominal esophagus was significantly shorter than that in the control group(P<0.05).The area under the ROC curve of His angle, abdominal esophageal length and their combination in the diagnosis of GER was 0.899,0.719 and 0.915,respectively.The sensitivity was 93.00%,64.50% and 90.00%,and the specificity was 76.00 %,72.00 % and 84.00 %,respectively.Conclusion:The gastrointestinal ultrasound parameters His angle and abdominal esophageal length have high value identifying infant GER,and the combined diagnostic value of the two is higher than that of a single index, which can be used as one of the auxiliary diagnostic methods for GER in infants.

关 键 词：胃食管反应 超声检查 婴幼儿 腹段食管长度 His角 

分 类 号：R445.1[医药卫生—影像医学与核医学] R571[医药卫生—诊断学]