超声检查对小儿十二指肠梗阻性疾病的诊断价值

doi:10.6040/j.issn.1671-7554.0.2017.823

摘要/Abstract

摘要： 目的探讨超声检查诊断小儿十二指肠肠梗阻性疾病的临床价值。方法回顾性分析188例经手术证实十二指肠梗阻性疾病的临床资料,将手术结果与术前超声诊断对照,总结该病的超声诊断要点。结果 188例经手术证实为十二指肠梗阻性疾病的患儿术前临床均有不同程度呕吐,声像图表现为胃至梗阻近端肠腔明显扩张积液,部分病例肠壁可增厚;梗阻远段肠管充盈差,甚至呈空瘪状态。术前超声诊断为十二指肠梗阻性疾病153例,包括十二指肠膜式闭锁或狭窄、环状胰腺、肠旋转不良等。这3类病变的超声诊断符合率分别为76.32%(29/38)、73.02%(46/63)及89.66%(78/87),其中部分患儿同时合并存在2种梗阻性病变。结论超声检查对小儿十二指肠梗阻性疾病的诊断及梗阻部位判断具重要价值,可作为小儿十二指肠梗阻性疾病的首选筛查方法。

关键词: 十二指肠梗阻, 超声检查, 小儿, 诊断

Abstract: Objective To investigate the clinical significance of ultrasonography in the diagnosis of duodenal obstruction in children. Methods The clinical data of 188 cases of duodenal obstruction confirmed by surgery in our hospital during Jan. 2011 and Dec. 2015 were retrospectively analyzed. The ultrasonographic results and surgical outcomes were compared to summarize the essentials of diagnosis. Results Before operation, all children had varying degrees of vomiting. Ultrasonographic images showed obvious dilation and effusion in the part between stomach and the proximal end of the obstructed intestinal cavity. In some cases, the bowel wall thickened. The distal end of obstructed intestinal cavity was poorly filled, or even empty. Ultrasonographic results indicated that 153 cases were duodenal obstruction, including duodenal atresia or stenosis, annular pancreas, and intestinal malrotation. The diagnostic accordance rate was 76.32%(29/38), 73.02%(46/63)and 89.66%(78/87), respectively. Some cases had 2 types of obstructions. Conclusion Ultrasonography plays an important role in the diagnosis of obstructive duodenal diseases and the location of obstructive site. It can serve as the first choice for screening duodenal obstruction in children.

Key words: Duodenal obstruction, Ultrasonography, Children, Diagnosis

中图分类号:

R699.2

毛羽,周昕. 超声检查对小儿十二指肠梗阻性疾病的诊断价值[J]. 山东大学学报 (医学版), 2018, 56(2): 47-50.

MAO Yu, ZHOU Xin. Diagnostic value of ultrasonography for duodenal obstruction in children[J]. Journal of Shandong University (Health Sciences), 2018, 56(2): 47-50.

参考文献

[1] 宋东建, 王家祥, 杨合英, 等. 新生儿十二指肠梗阻35例临床分析[J]. 中华小儿外科杂志, 2013, 34(7): 549-550. SONG Dongjian, WANG Jiaxiang, YANG Heying, et al. Clinical analysis of 35 cases of neonatal duodenal obstruction[J]. Chin J Pediatr Surg, 2013, 34(7): 549-550.
[2] 郭细军, 王志强, 莫崖冰. 先天性十二指肠梗阻的诊断与外科治疗[J]. 临床小儿外科杂志, 2004, 3(3): 214-216. GUO Xijun, WANG Zhiqiang, MO Yabing. Experience of diagnosis and surgical treatment for congenital duodenal obstruction[J]. Journal of Clinical Pediatric Surgery, 2004, 3(3): 214-216.
[3] Brinkley MF, Tracy ET, Maxfield CM. Congenital duodenal obstruction: causes and imaging approach[J]. Pediatr Radiol, 2016, 46(8):1084-1095.
[4] Maheshwari P, Abograra A, Shamam O. Sonographic evaluation of gastrointestinal obstruction in infants: a pictorial essay[J]. J Pediatr Surg, 2009, 44(10): 2037-2042.
[5] 米荣, 康利民, 马继东, 等. 先天性肠旋转不良84例[J]. 实用儿科临床杂志, 2012, 27(15): 1204-1206. MI Rong, KANG Limin, MA Jidong, et al. Clinical presentation of 84 infantile cases with malrotation of intestine[J]. J Appl Clin Pediatr, 2012, 27(15):1204-1206.
[6] 李炳, 陈卫兵, 王寿青, 等. 腹腔镜诊治新生儿十二指肠梗阻[J]. 中华小儿外科杂志, 2011, 32(1): 71-72. LI Bing, CHEN Weibing, WANG Shouqing, et al. Laparoscopic diagnosis and treatment of neonatal duodenal obstruction[J]. Chin J Pediatr Surg, 2011, 32(1): 71-72.
[7] Kilbride H, Castor C, Andrews W. Congenital duodenal obstruction: timing of diagnosis during the new born period[J]. J Perinatol, 2010, 30(3): 197-200.
[8] 张雪华, 陈文娟, 张号绒, 等. 超声诊断新生儿先天性小肠闭锁[J]. 中国医学影像学杂志, 2014, 22(8): 638-640. ZHANG Xuehua, CHEN Wenjuan, ZHANG Haorong, et al. Ultrasound diagnosis of congenital atresia of small intestine in neonates[J]. Chinese Journal of Medical Imaging, 2014, 22(8): 638-640.
[9] 王峥嵘, 张玉林, 苏英姿, 等. 超声在先天性肠旋转不良及中肠扭转诊断中的价值[J]. 中华超声影像学杂志, 2014, 23(3): 243-246. WANG Zhenrong, ZHANG Yulin, SU Yingzi, et al. Value of ultrasound in the diagnosis of congenital intestinal malrotation and midgut volvulus[J]. Chin J Ultrasonogr, 2014, 23(3): 243-246.
[10] 段星星, 李皓, 陈文娟, 等. 高频超声对新生儿环状胰腺的诊断价值[J]. 中国超声医学杂志, 2014, 30(8): 760-762. DUAN Xingxing, LI Hao, CHEN Wenjuan, et al. Value of high-frequency ultrasound in the diagnosis of neonates with annular pancreas[J]. Chinese J Ultrasound Med, 2014, 30(8): 760-762.
[11] 张文花, 丁红宇, 王慧, 等. 高频超声诊断新生儿环状胰腺的价值[J]. 中华超声影像学杂志, 2014, 23(5): 423-426. ZHANG Wenhua, DING Hongyu, WANG Hui, et al. Diagnostic value of high frequency ultrasonography in neonatal annular pancreas[J]. Chin J Ultrasonogr, 2014, 23(5): 423-426.
[12] 陈子民, 叶明, 卢可士, 等. 先天性十二指肠隔膜型肠梗阻诊治分析[J]. 临床小儿外科杂志, 2012, 11(3): 196-198. CHEN Zimin, YE Ming, LU Keshi, et al. The diagnosis and treatment of congenital duodenal diaphragmatic obstruction[J]. Journal of Clinical Pediatric Surgery, 2012, 11(3): 196-198.
[13] 邵雷朋, 侯广军. 先天性十二指肠梗阻的诊治与分析[J]. 中国实用药学, 2009, 4(16): 114-115. SHAO Leipeng, HOU Guangjun. Diagnosis and treatment of congenital duodenal obstruction[J]. China Prac Med, 2009, 4(16): 114-115.
[14] 陈青江, 楼毅, 高志刚, 等. 新生儿先天性十二指肠梗阻[J]. 中华小儿外科杂志, 2013, 34(10): 746-749. CHEN Qingjiang, LOU Yi, GAO Zhigang, et al. Congenital duodenal obstruction in infants[J]. Chin J Pediatr Surg, 2013, 34(10): 746-749.

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