彩色超声检查在小儿肠套叠诊断及临床治疗策略制定中的临床应用  

Clinical Application of Color Doppler Ultrasonography in Diagnosis and Clinical Treatment Strategy of Children with Intussusception

作　　者：张艳艳 黄正赤 陈凯琳 ZHANG Yan-yan;HUANG Zheng-chi;CHEN Kai-lin(Department of Ultrasound,The Second People's Hospital of Luohe,Luohe 462000,China)

机构地区：[1]漯河市第二人民医院超声科,漯河462000

出　　处：《四川解剖学杂志》2024年第2期4-7,共4页Sichuan Journal of Anatomy

摘　　要：目的:探讨彩色超声检查在小儿肠套叠诊断及临床治疗策略制定中的应用价值.方法:选取 2022 年 1 月至2023 年 1 月本院收治的 119 例疑似肠套叠患儿中 106 例临床最终确诊肠套叠患儿为研究对象.按照是否采取手术治疗策略,将其分为手术组(n=34)和非手术组(n=72).本研究以经灌肠复位或手术结果为诊断小儿肠套叠诊断"金标准",评估彩色超声检查效能.采用多因素非条件Logistic回归法分析导致肠套叠患儿手术治疗的相关因素.结果:本研究小儿肠套叠确诊率为 89.1%(106/119).彩色超声检查对小儿肠套叠的诊断与临床诊断结果一致性极强(Kappa=0.838),诊断灵敏度为 97.17%、特异度为 92.31%.手术组套叠直径、套叠长度、肠壁厚度、阻力指数均大于非手术组,肠管扩张、淋巴结肿大、星点状血流、腹腔游离液体占比超过非手术组,差异均有统计学意义(P<0.05).经多因素非条件Logistic回归分析,星点状血流、套叠直径、套叠长度、肠壁厚度、阻力指数均为导致肠套叠患儿手术治疗的独立危险因素(OR>1,P<0.05).结论:彩色超声检查对小儿肠套叠诊断效能佳,通过分析超声影像学表现,可为患儿临床治疗策略提供参考.Objective:To explore clinical application value of color ultrasonography in diagnosis and clinical treatment strategies of children with intussusception.Methods:A total of 119 children with suspected intussusception in our hospital from January 2022 to January 2023 were selected as the study subjects.Among them 106 children were finally diagnosed of intussusception.According to treatment method,they were divided into surgical group(n=34)and non-surgical group(n=72).In this study,using the results of enema reduction or operation as the"gold standard"for the diagnosis of children with intussusception,the diagnostic effect of color ultrasound on pediatric intussusception was evaluated.The relevant factors of surgical treatment in children with intussusception were analyzed by multivariate unconditional logistic regression.Results:Diagnosis rate of children with intussusception was 89.1%(106/119).The consistency between color ultrasound diagnosis and clinical results of pediatric intussusception was extremely strong(Kappa=0.838),with a diagnostic sensitivity of 97.17%and a specificity of 92.31%.The intussusception diameter,intussusception length,intestinal wall thickness,and resistance index in surgical group were larger than those in non-surgical group,and proportion of intestinal dilatation,lymph node enlargement,stellate blood flow,and free peritoneal fluid in surgical group were higher than those in non-surgical group,the differences were statistically significant(P<0.05).Through multivariate unconditional logistic regression analysis,stellate blood flow,intussusception diameter,intussusception length,intestinal wall thickness,and resistance index were independent risk factors that affect the surgical treatment of children with intussusception(OR>1,P<0.05).Conclusion:Color ultrasound has excellent diagnostic efficacy for pediatric intussusception,and analyzing ultrasound imaging findings can provide reference for clinical treatment strategies in pediatric patients.

关 键 词：肠套叠 小儿 诊断 鉴别 超声检查 临床方案 危险因素 

分 类 号：R725.7[医药卫生—儿科]