超声监视下水压灌肠在儿童继发性肠套叠中的病因诊断价值  

The Etiological Diagnostic Value of Ultrasound-guided Hydraulic Enema in Children with Intussusception Secondary

作　　者：陈泽坤 李雅雅 戴泽艺 陈晓康 Chen Zekun;Li Yaya;Dai Zeyi;Chen Xiaokang(Department of Medical Ultrasounics,Xiamen Children's Hospital,Xiamen,Fujian 361006,China)

机构地区：[1]厦门市儿童医院超声医学科,福建省厦门市361006

出　　处：《中国超声医学杂志》2023年第6期693-695,共3页Chinese Journal of Ultrasound in Medicine

基　　金：厦门市医疗卫生指导项目(No.3502Z20214ZD1250);厦门市儿童医院骨干人才培育科研项目(No.CHP-2019-BT-A005)。

摘　　要：目的探讨超声监视下水压灌肠对儿童继发性肠套叠的病因诊断价值。方法回顾性分析32例继发性肠套叠患儿的临床及超声资料,总结超声特点及临床价值。结果①32例患儿经超声监视下水压灌肠诊断病理诱发点25例,单纯超声诊断13例,超声监视下水压灌肠的病因诊断符合率高于单纯超声诊断(P<0.01)。19例复位成功行择期手术,6例复位失败转手术治疗,7例漏误诊。②继发性肠套叠以肠息肉、淋巴瘤居多,复位成功率高。③梅克尔憩室、阑尾炎伴粘连、腹型紫癜继发肠套叠灌肠易失败,复位失败且病因不明应首先考虑梅克尔憩室。④弥漫性淋巴瘤及腹型紫癜易误诊为回盲瓣炎性水肿。结论超声监视下水压灌肠在继发性肠套叠的病因诊断中具有较高价值,可为临床治疗方案的选择提供影像依据。Objective To investigate the etiological diagnostic value of ultrasound-guided hydraulic enema in children with intussusception secondary.Methods The clinical and ultrasound data of 32 cases of intussusception secondary were retrospectively collected and analyzed.Results①Among the 32 children,the pathological trigger points were diagnosed by ultrasound-guided hydraulic enema in 25 cases,while only 13 were diagnosed by simple ultrasonography.The coincidence rate of ultrasound-guided hydraulic enema in etiological diagnosis was higher than that of simple ultrasonography(P<0.01).Successful reduction and elective surgery was performed in 19 cases,while 6 cases underwent failed reduction and converted to surgery.A total of 7 cases were misdiagnosed.②The intussusception secondary was mainly caused by intestinal polyps and lymphoma which had high reset success rate.Failed reduction was more often seen in patients with Meckel's diverticulum,appendicitis with perforation and abdominal type allergic purpura.Meckel's diverticulum should be considered first if the reset failed for no particular reason.The diffuse lymphoma and the abdominal purpura were easily misdiagnosed as inflammatory edema of the ileocecal region.Conclusions Ultrasound-guided hydraulic enema reduction has a high value in the etiological diagnosis of intussusception secondarys,and provides guidance for the clinical decision making.

关 键 词：超声 水压灌肠 继发性肠套叠 病因诊断 

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]