新生儿小肠扭转与中肠扭转的超声表现对比分析  

Comparative Analysis of Sonographic Findings Between Small Bowel Volvulus and Midgut Volvulus in Newborn

作　　者：张琛 秦鸣 杜颖 董娟 Zhang Chen;Qin Ming;Du Ying;Dong Juan(Department of Ultrasound Medicine,Xuzhou Children’s Hospital,Xuzhou Medical University,Xuzhou,Jiangsu 221006,China)

机构地区：[1]徐州医科大学附属徐州儿童医院超声医学科,江苏省徐州市221006

出　　处：《中国超声医学杂志》2023年第8期911-914,共4页Chinese Journal of Ultrasound in Medicine

基　　金：徐州市儿童医院2022年度科研项目(No.22040432)。

摘　　要：目的探讨新生儿小肠扭转的临床特征和超声表现,分析其与中肠扭转的差异。方法回顾性分析进行术前超声检查且手术病理证实的101例新生儿肠扭转的临床和超声资料,按手术病理结果分为小肠扭转组和中肠扭转组,比较两组间临床特征及超声征象的差异。结果两组间发病年龄、伴发肠坏死及合并消化道畸形的差异均有统计学意义(P<0.05)。两组间超声图像对比,漩涡征/血管螺旋征、肠梗阻征象、肠缺血坏死征象和其他征象(囊性肿块、钙化)的差异均具有统计学意义(P<0.05)。ROC结果显示,肠梗阻征象、肠缺血坏死征象和其他征象预测新生儿小肠扭转的AUC分别为0.727、0.786和0.565。结论相对于中肠扭转,新生儿小肠扭转的发病年龄更小,合并的消化道畸形更多,容易肠坏死;小肠扭转超声图像的漩涡征不明显,更多表现为缺血坏死征象。Objective To investigate the clinical features and ultrasonic manifestations of small bowel volvulus in newborn,and analyze the differences between it and midgut volvulus.Methods The clinical and ultrasonic data of 101 newborns with intestinal volvulus confirmed by operation and pathology and preoperative ultrasound examination were retrospectively analyzed.According to the pathological results,the cases were divided into small bowel volvulus group and midgut volvulus group,and the differences of clinical features and ultrasonic signs between the two groups were compared.Results There were significant differences in age of onset,intestinal necrosis and gastrointestinal malformation between the two groups(P<0.05).Comparison of the ultrasonic images between the two groups showed statistically significant differences in whirlpool sign/vascular spiral sign,intestinal obstruction sign,intestinal ischemic necrosis sign and other signs(cystic mass,calcification)(P<0.05).The results of ROC showed that the AUC of intestinal obstruction,intestinal ischemic necrosis and other signs predicting neonatal small bowel volvulus were 0.727,0.786and 0.565,respectively.Conclusions Compared with midgut volvulus,the onset age of small bowel volvulus is younger,and more gastrointestinal malformation are associated with intestinal necrosis.The whirlpool sign in the ultrasonic image of small bowel volvulus is not obvious,but the more shows the sign of ischemic necrosis.

关 键 词：小肠扭转 中肠扭转 新生儿 超声检查 

分 类 号：R722.1[医药卫生—儿科] R445.1[医药卫生—临床医学]