CAJ | 학술논문

目的总结脐部两孔L腹腔镜结合ECT(emission computed tomography,ECT)在小儿小肠出血诊断和治疗中的应用经验.方法我院2004年1月至2010年12月共收治167例消化道出血患儿,其中72例患儿反复便血患儿进行99m锝酸盐(99mTc)显像检查,均行腹腔镜探查术.结果 72例中59例ECT阳性患儿均经腹腔镜探查及病理证实,其中47例梅克尔憩室,9例小肠重复畸形,3例为血管瘤；13例ECT阴性患儿7例经手术及病理证实为梅克尔憩室,2例为肠重复畸形,1例蓝色橡皮疱痣综合征,2例为过敏性紫癜导致的肠道出血,1例未见器质性病变.以上患儿均治愈,术后随访3个月至6年未见出血.结论 ECT检查可作为小肠出血的首选无创检查.脐部两孔腹腔镜结合ECT检查对小儿小肠出血不仅可以提高诊断率,而且又具有治疗价值,切口美观,创伤小,并可减少开腹探查的盲目性及创伤性.
목적 총결제부량공L복강경결합ECT(emission computed tomography,ECT)재소인소장출혈진단화치료중적응용경험.방법 아원2004년1월지2010년12월공수치167례소화도출혈환인,기중72례환인반복편혈환인진행99m득산염(99mTc)현상검사,균행복강경탐사술.결과 72례중59례ECT양성환인균경복강경탐사급병리증실,기중47례매극이게실,9례소장중복기형,3례위혈관류；13례ECT음성환인7례경수술급병리증실위매극이게실,2례위장중복기형,1례람색상피포지종합정,2례위과민성자전도치적장도출혈,1례미견기질성병변.이상환인균치유,술후수방3개월지6년미견출혈.결론 ECT검사가작위소장출혈적수선무창검사.제부량공복강경결합ECT검사대소인소장출혈불부가이제고진단솔,이차우구유치료개치,절구미관,창상소,병가감소개복탐사적맹목성급창상성.
Objective To explore the clinical application value of two-port laparoscopy combined with emission computed tomography (FCT) in diagnosis and therapy of pediatric small intestine hemorrhage.Methods 167 children associated with gastrointestinal hemorrhage were admitted in our center from January 2004 to December 2009.99mTc-pertechnetate abdominal scintigraphy was performed in 72 patients with a history of recurrent hemafecia or melena,and they were targeted for present study.All the 72 patients underwent laparoscopic exploration.Results Among the 72 patients,59 patients showed positive results in scintigraphy.They were further confirmed by laparoscopic surgery and pathological examinations,including Meckel's diverticulum in 47 and duplications of alimentary tract in 9,and angioma in 3.Remain 13 patients with negative scintigraphy were shown Meckel's diverticulum in 7,duplications of alimentary tract in 2,blue rubber bleb nerus syndrome in 1,and anaphylactoid purpura in 2 via laparoscopic surgery and pathogenic examination,and no organic pathologic changes was identified by laparoscopy in 1 patient.All of them recoverd after therapy.No further bleeding was seen in follow-up.Conclusions ECT is an important candidate in diagnosis of small intestine hemorrhage in children.The combination of laparoscopy and radionuclide imaging not only brings benefit to diagnosis and treatment in such patients,but also effectively reduce the damage by conventional open exploratory laparotomy.