超声对诊断小儿结肠炎的准确性及在预后评估中的应用价值
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摘要
目的:研究与分析超声对诊断小儿结肠炎的准确性及预后评估中的应用价值。方法:选取本院2014年1月1日-2017年12月31日收治的45例小儿结肠炎患儿为研究对象,回顾性分析其全部的临床资料,所有患儿均实施超声检查。以内镜检查结果为金标准,观察分析超声诊断小儿结肠炎的准确性以及超声表现。结果:经超声检查,45例患者中肠壁增厚诊断准确性为91.11%(41/45),即41例患儿肠壁厚度>4 mm;而炎症部位诊断准确性为84.44%(38/45)。超声表现:患儿腹部可见相应结肠肠壁肿胀,肠管壁增厚,以黏膜及黏膜下层为主,严重时累及全结肠,层次消失,且回声减低不均;肠管蠕动未见异常,可有肿大的系膜淋巴结,CDFI:增厚肠壁探及稍丰富血流信号,无明显肠气回声,肠腔狭窄,病变呈环形;腹腔可见少量液性暗区,最大深度约11 mm。超声提示存在节段性肠管壁增厚,待排腹型紫癜或肠炎声像;少量腹水等。结论:小儿结肠炎采用超声诊断具有较高准确性,且具有重复性好、无创安全等优势,因此可为小儿结肠炎预后评估提供可靠依据。
Objective:To study and analyze the accuracy of ultrasound in diagnosis of children with colitis and its application in prognosis evaluation.Method:A total of 45 children with colitis(2-16 years) in our hospital from January 1,2014 to December 31,2017 were enrolled in this study.All clinical data were retrospectively analyzed.All children Ultrasound examination was performed.To endoscopy as the gold standard,the accuracy of ultrasound diagnosis of children with colitis and ultrasound performance were observed and analyzed.Result:The diagnostic accuracy of the midgut wall thickening was 91.11%(41/45)in 45 children,the thickness of the intestinal wall in 41 children>4 mm.The diagnostic accuracy of the inflammation site was 84.44%(38/45).Ultrasonography:The left flank of the child was thickening of the intestinal wall,mainly to the mucosa and submucosa,involved the whole colon,and reduced the echo;intestinal peristalsis was no abnormality.CDFI:A little rich blood flow signals,no obvious intestinal gas echo,intestinal stenosis,lesions were annulus;few liquid dark areas were found in abdominal cavity,the maximum depth was 11 mm.Ultrasound prompted the existence of segmental bowel wall thickening,to be discharged row of purpura or enteritis pancreas;a small amount of ascites.Conclusion:Ultrasound diagnosis is high accuracy in children with colitis,and has good repeatability,non-invasive safety and other advantages,it can provide a reliable basis for the assessment of prognosis in children with colitis.
Objective:To study and analyze the accuracy of ultrasound in diagnosis of children with colitis and its application in prognosis evaluation.Method:A total of 45 children with colitis(2-16 years) in our hospital from January 1,2014 to December 31,2017 were enrolled in this study.All clinical data were retrospectively analyzed.All children Ultrasound examination was performed.To endoscopy as the gold standard,the accuracy of ultrasound diagnosis of children with colitis and ultrasound performance were observed and analyzed.Result:The diagnostic accuracy of the midgut wall thickening was 91.11%(41/45)in 45 children,the thickness of the intestinal wall in 41 children>4 mm.The diagnostic accuracy of the inflammation site was 84.44%(38/45).Ultrasonography:The left flank of the child was thickening of the intestinal wall,mainly to the mucosa and submucosa,involved the whole colon,and reduced the echo;intestinal peristalsis was no abnormality.CDFI:A little rich blood flow signals,no obvious intestinal gas echo,intestinal stenosis,lesions were annulus;few liquid dark areas were found in abdominal cavity,the maximum depth was 11 mm.Ultrasound prompted the existence of segmental bowel wall thickening,to be discharged row of purpura or enteritis pancreas;a small amount of ascites.Conclusion:Ultrasound diagnosis is high accuracy in children with colitis,and has good repeatability,non-invasive safety and other advantages,it can provide a reliable basis for the assessment of prognosis in children with colitis.
引文
[1]刘巍.腹部B超在新生儿坏死性小肠结肠炎诊断中的价值[J].世界最新医学信息文摘,2016,16(4):150,153.
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[5]石群峰,李新宁.腹腔镜辅助Soave根治术治疗小儿先天性巨结肠的手术并发症及防治措施[J].腹腔镜外科杂志,2013,18(3):177-182.
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[11]张阳,姜忠强,庞焕平,等.高频超声在新生儿阑尾炎中的诊断价值[J].医学影像学杂志,2017,27(10):1945-1948.
[12]张文,陈凯,马丽,等.小儿消化内镜临床应用研究进展[J].武警后勤学院学报(医学版),2017,26(8):729-732.
[13]石群峰,曾甜.腹腔镜辅助Soave手术与开腹手术治疗小儿结肠冗长症的对比研究[J].腹腔镜外科杂志,2014,19(3):197-201.
[14]程广明.多层螺旋CT诊断小儿阑尾炎133例临床价值分析[J].现代医药卫生,2014,30(17):2642-2643.
[15]唐毅,计晓娟,杨春江,等.超声诊断新生儿坏死性小肠结肠炎的临床价值[J].第三军医大学学报,2012,34(13):1347-1349.
[16]王政,刘贵麟,苏刚,等.先天性巨结肠合并小肠结肠炎的临床分析[J].军医进修学院学报,2012,33(10):1013-1014.
[17]牟芳婷,唐毅.超声诊断新生儿坏死性小肠结肠炎的研究进展[J].中国医学影像技术,2016,32(12):1943-1946.
[18]胡浩清,费维,曹蓉蓉,等.灰阶超声结合能量多普勒在炎症性肠病诊断中的价值[J].中华医院感染学杂志,2017,27(1):117-119.
[19]姬响华,王文华,郭凯娜.肠内置管外引流术治疗新生儿坏死性小肠结肠炎的疗效分析[J].东南大学学报(医学版),2017,36(4):542-546.
[20]徐晓蓉,徐辉雄,刘畅,等.肠道超声对炎症性肠病诊断和活动性评估的前瞻性研究[J].胃肠病学和肝病学杂志,2013,22(10):1013-1016.
[2]褚洪光,王鹏.新生儿坏死性小肠结肠炎应用超声诊断的临床价值[J].现代消化及介入诊疗,2016,21(1):79-80.
[3]梅红,张蓉,宫少青,等.腹部超声诊断小儿结肠炎的准确性及其对预后的评估价值[J].结直肠肛门外科,2016,22(1):31-33.
[4]孙华阳.腹部超声应用于幼儿坏死性小肠结肠炎临床诊断的有效性分析[J].黑龙江医药,2016,29(5):933-935.
[5]石群峰,李新宁.腹腔镜辅助Soave根治术治疗小儿先天性巨结肠的手术并发症及防治措施[J].腹腔镜外科杂志,2013,18(3):177-182.
[6]邓尚国.超声对新生儿坏死性小肠结肠炎的诊断价值[J].深圳中西医结合杂志,2015,25(6):68-69.
[7]朱峰.超声诊断新生儿坏死性小肠结肠炎的临床价值[J].中国当代医药,2015,22(15):53-54,58.
[8]李洪,金先庆.新生儿先天性巨结肠诊断与治疗研究进展[J].现代医药卫生,2015,31(13):1966-1969.
[9]肖苏兰.超声检查在小儿便血病因诊断中的应用[J].长江大学学报(自科版),2015,12(30):40-41.
[10]刘斌.新生儿坏死性小肠结肠炎外科诊疗进展[J].中国普通外科杂志,2015,24(10):1463-1467.
[11]张阳,姜忠强,庞焕平,等.高频超声在新生儿阑尾炎中的诊断价值[J].医学影像学杂志,2017,27(10):1945-1948.
[12]张文,陈凯,马丽,等.小儿消化内镜临床应用研究进展[J].武警后勤学院学报(医学版),2017,26(8):729-732.
[13]石群峰,曾甜.腹腔镜辅助Soave手术与开腹手术治疗小儿结肠冗长症的对比研究[J].腹腔镜外科杂志,2014,19(3):197-201.
[14]程广明.多层螺旋CT诊断小儿阑尾炎133例临床价值分析[J].现代医药卫生,2014,30(17):2642-2643.
[15]唐毅,计晓娟,杨春江,等.超声诊断新生儿坏死性小肠结肠炎的临床价值[J].第三军医大学学报,2012,34(13):1347-1349.
[16]王政,刘贵麟,苏刚,等.先天性巨结肠合并小肠结肠炎的临床分析[J].军医进修学院学报,2012,33(10):1013-1014.
[17]牟芳婷,唐毅.超声诊断新生儿坏死性小肠结肠炎的研究进展[J].中国医学影像技术,2016,32(12):1943-1946.
[18]胡浩清,费维,曹蓉蓉,等.灰阶超声结合能量多普勒在炎症性肠病诊断中的价值[J].中华医院感染学杂志,2017,27(1):117-119.
[19]姬响华,王文华,郭凯娜.肠内置管外引流术治疗新生儿坏死性小肠结肠炎的疗效分析[J].东南大学学报(医学版),2017,36(4):542-546.
[20]徐晓蓉,徐辉雄,刘畅,等.肠道超声对炎症性肠病诊断和活动性评估的前瞻性研究[J].胃肠病学和肝病学杂志,2013,22(10):1013-1016.