大数据探究超声检查对坏死性小肠结肠炎的诊断作用  

Diagnostic effect of ultrasound examination in necrotizing enterocolitis by big data

作　　者：张慧 龚放[1] 温鑫 徐鑫苑 张翼飞 史怡悦 ZHANG Hui;GONG Fang;WEN Xin;XU Xinyuan;ZHANG Yifei;SHI Yiyue(Department of Pediatrics,Affiliated Yongchuan Hospital,Chongqing Medical University,Chongqing 402100,China;Institute of Medical Data,Information College,Chongqing Medical University,Chongqing 400016,China)

机构地区：[1]重庆医科大学附属永川医院儿科,402100 [2]重庆医科大学医学信息学院医学数据研究院,400016

出　　处：《重庆医学》2022年第24期4169-4174,共6页Chongqing medicine

基　　金：国家自然科学基金项目(81270058);重庆医科大学智慧医学研究项目(YJSZHYX202023)。

摘　　要：目的对比新生儿坏死性小肠结肠炎(NEC)的腹部超声(AUS)及腹部X线片(AXR)表现,探究AUS检查对NEC的诊断意义。方法利用重庆医科大学医渡云医学数据研究院平台收集2012年5月至2017年6月383例NEC患儿的临床资料进行回顾性分析,按AUS和AXR检查时间分为早期检查组(检查时间为入院前门诊或入院后24 h内,226例)和晚期检查组(检查时间大于入院后24 h,157例),按出生体重分为低出生体重组(出生体重小于2500 g,96例)和正常出生体重组(出生体重大于或等于2500 g,287例),按临床表现(部分病例临床表现信息丢失,检索后获得249例含临床表现的患儿)分为腹胀组(96例)、呕吐组(82例)、血便/呕血组(52例)和反应差组(19例)。比较各组患儿AXR、AUS检查结果。结果早期检查组患儿AUS检查肠壁增厚、腹腔积液检出率均高于AXR,AXR检查肠腔扩张、肠腔胀气、肠壁积气、肠管僵硬检出率均高于AUS;晚期检查组患儿AUS检查肠壁增厚、门静脉积气、肠蠕动缓慢、腹腔积液的检出率均高于AXR,AXR检查肠腔扩张、肠腔胀气、肠壁积气、肠管僵硬的检出率均高于AUS。低出生体重组患儿AUS检查肠壁增厚、门静脉积气、腹腔积液的检出率均高于AXR,AXR检查肠腔扩张、肠腔胀气、肠壁积气、肠管僵硬的检出率均高于AUS;正常出生体重组患儿AUS检查肠壁增厚、腹腔积液的检出率均高于AXR,AXR检查肠腔扩张、肠腔胀气、肠壁积气、肠管僵硬检出率均高于AUS。腹胀组患儿AUS检查肠壁增厚、腹腔积液检出率均高于AXR,腹胀组患儿AUS检查肠壁增厚、腹腔积液检出率均高于AXR,呕吐组、血便/呕血组、反应差组患儿AUS检查腹腔积液检出率均高于AXR。结论AUS检查对NEC的诊断具有重要意义,值得临床推广应用。Objective To compare the abdominal X-ray(AXR)and abdominal ultrasound(AUS)manifestations of neonatal necrotizing enterocolitis(NEC),and to investigate the diagnostic significance of AUS examination for NEC.Methods The clinical data of 383 cases of NEC from May 2012 to June 2017 were collected by using the platform of Yiduyun Medical Data Research Institute of Chongqing Medical University and conducted the retrospective analysis.According to the examination time of AUS and AXR,they were divided into the early examination group(examination time was in the outpatient department before admission or within 24 h after admission,226 cases)and late examination group(the examination time was greater than 24 h after admission,n=157),according to the birth weight,they were divided into the low birth weight group(birth weight<2500 g,n=96)and normal birth weight group(birth weight≥2500 g,n=287),according to the clinical manifestations(the clinical manifestations information of some cases were lost.A total of 249 cases with clinical manifestations were obtained after retrieval),they were divided into the abdominal distension group(n=96),vomiting group(n=82),hematochezia/hematemesis group(n=52)and poor response group(n=19).The results of AXR and AUS examination were compared among the groups.Results In the early examination group,the detection rate of AUS for intestinal wall thickening and ascites was higher than that of AXR;the detection rate of AXR for intestinal dilatation,intestinal distention,intestinal wall pneumatosis,and intestinal stiffness was higher than that of AUS.In the late examination group,the detection rate of AUS for intestinal wall thickening,portal vein pneumatosis,slow intestinal peristalsis and ascites was higher than that of AXR.The detection rate of AXR for intestinal dilatation,intestinal distention,intestinal wall pneumatosis and intestinal stiffness was higher than that of AUS.In the low birth weight group,the detection rate of AUS for intestinal wall thickening,portal vein pneumatosis,and ascites

关 键 词：医疗大数据 新生儿 坏死性小肠结肠炎 腹部超声 腹部X线片 诊断 

分 类 号：R722.1[医药卫生—儿科]