基于床旁腹部卧位X线检查的新生儿气腹征象探讨  

Exploration of pneumoperitoneum signs in neonates based on X-ray examination of bedside abdominal lying film

作　　者：杨绍伟 陈瑜[1] 周婧 肖霞 马慧静[1] YANG Shaowei;CHEN Yu;ZHOU Jing;XIAO Xia;MA Huijing(Department of Radiology,Wuhan Children’s Hospital,Tongji Medical College,Huazhong University of Science&Technology,Wuhan 430016,China;Department of Maternal and Child Ultrasound Imaging,Wuhan Children’s Hospital,Tongji Medical College,Huazhong University of Science&Technology,Wuhan 430016,China)

机构地区：[1]华中科技大学同济医学院附属武汉儿童医院放射影像科,湖北武汉430016 [2]华中科技大学同济医学院附属武汉儿童医院妇幼超声影像科,湖北武汉430016

出　　处：《实用放射学杂志》2024年第2期281-284,共4页Journal of Practical Radiology

摘　　要：目的探讨床旁腹部卧位片上的新生儿气腹征象。方法回顾性分析52例新生儿气腹的床旁腹部卧位片上气腹征象。结果52例新生儿气腹中2例未见穿孔点;50例为消化道穿孔,胃、小肠及大肠穿孔分别为22例、17例及11例;穿孔原因以先天性胃壁肌层缺损及坏死性小肠结肠炎(NEC)最多见。43例仅拍摄正位片,均见气腹征象;9例拍摄正位片+侧位片,其中6例正位片和侧位片均见气腹征象,3例仅侧位片见气腹征象。气腹征象包括肝镰状韧带征38次、足球征37次、Rigler征22次、肝圆韧带征21次、肝区透亮影10次、反“V”征9次、阴囊积气6次、三角征5次、Cupola征4次及海豚征1次。46例见2个及以上征象,31例见3个及以上征象。气腹征象在胃、小肠及大肠穿孔3组间的差异除阴囊积气外均无统计学意义(P>0.05)。结论新生儿气腹在床旁腹部卧位片上可见肝镰状韧带征、足球征、Rigler征及肝圆韧带征等多种征象,认识上述征象有利于快速准确诊断。Objective To explore the pneumoperitoneum signs of neonates on the bedside abdominal lying film.Methods The pneumoperitoneum signs of 52 neonates on the bedside abdominal lying films were analyzed retrospectively.Results Among 52 neonates with pneumoperitoneum,2 cases had no perforation,and there were 50 cases of digestive tract perforation,with 22 cases of gastric perforation,17 cases of small intestinal perforation and 11 cases of large intestinal perforation.Congenital muscular defect of gastric wall and necrotizing enterocolitis(NEC)were the most common causes of perforation.Forty-three cases with anteroposterior films all had pneumoperitoneum signs;and in 9 cases with anteroposterior and lateral films,6 cases with anteroposterior and lateral films all showed pneumoperitoneum signs,while 3 cases showed pneumoperitoneum signs only on lateral films.Pneumoperitoneum signs included 38 episodes of liver falciform ligament signs,37 episodes of football signs,22 episodes of Rigler signs,21 episodes of round liver ligament signs,10 episodes of liver area bright shadows,9 episodes of inverted“V”signs,6 episodes of scrotal gas,5 episodes of triangular signs,4 episodes of Cupola signs and 1 episodes of dolphin sign.Two or more signs were seen in 46 cases and three or more signs were seen in 31 cases.There was no statistically significant difference in the pneumoperitoneum signs except for scrotal gas among the three groups of gastric,small intestinal and large intestinal perforations(P>0.05).Conclusion Various signs such as liver falciform ligament signs,football signs,Rigler signs and round liver ligament signs can be seen on the bedside abdominal lying film for neonates pneumoperitoneum,and understanding the above signs is conducive to rapid and accurate diagnosis.

关 键 词：气腹 新生儿 放射摄影术 

分 类 号：R722[医药卫生—儿科] R814.41[医药卫生—临床医学]