中国基层医药
中國基層醫藥
중국기층의약
CHINESE JOURNAL OF PRIMARY MEDICINE AND PHARMACY
2015年
9期
1339-1341,后插1
,共4页
肠套叠%灌肠%超声检查,介入性%儿童
腸套疊%灌腸%超聲檢查,介入性%兒童
장투첩%관장%초성검사,개입성%인동
Intussusception%Treatment%Ultrasonography,interventional%Child
目的 探讨灌肠下小儿肠套叠的超声图像及超声引导下0.9％氯化钠溶液灌肠对小儿继发性肠套叠的诊断和治疗价值.方法 回顾性分析23例小儿继发性肠套叠病例资料,总结不同病因引起的继发性肠套叠的超声图像特点.结果 麦克尔憩室8例,幼年性息肉4例,囊肿型肠重复畸形4例,淋巴瘤3例,阑尾炎2例,肠粘连2例.23例继发性肠套叠均于首次超声检查明确肠套叠诊断,其中22例超声引导下0.9％氯化钠溶液灌肠复位成功,1例复位失败.13例于首次灌肠诊断为继发性肠套叠(麦克尔憩室6例,幼年性息肉3例,肠重复畸形2例,淋巴瘤1例,阑尾炎1例),9例肠套叠复发后再行0.9％氯化钠溶液灌肠复位术,诊断为继发性肠套叠(麦克尔憩室2例,幼年性息肉1例,肠重复畸形2例,淋巴瘤2例,阑尾炎1例,肠粘连1例).结论 麦克尔憩室、肠息肉及肠重复畸形是最常见的引起小儿继发性肠套叠的病理诱发点,超声对小儿肠套叠诊断的敏感性高,并且可在超声监视下行0.9％氯化钠溶液灌肠复位术,其复位效果优于X线空气灌肠,操作者可实时进行超声观察,了解肠套叠的复位情况,充满0.9％氯化钠溶液的肠腔更利于超声医生观察,及早发现引起肠套叠的病理诱发点,为继发性肠套叠的外科临床治疗提供重要的影像依据.
目的 探討灌腸下小兒腸套疊的超聲圖像及超聲引導下0.9％氯化鈉溶液灌腸對小兒繼髮性腸套疊的診斷和治療價值.方法 迴顧性分析23例小兒繼髮性腸套疊病例資料,總結不同病因引起的繼髮性腸套疊的超聲圖像特點.結果 麥剋爾憩室8例,幼年性息肉4例,囊腫型腸重複畸形4例,淋巴瘤3例,闌尾炎2例,腸粘連2例.23例繼髮性腸套疊均于首次超聲檢查明確腸套疊診斷,其中22例超聲引導下0.9％氯化鈉溶液灌腸複位成功,1例複位失敗.13例于首次灌腸診斷為繼髮性腸套疊(麥剋爾憩室6例,幼年性息肉3例,腸重複畸形2例,淋巴瘤1例,闌尾炎1例),9例腸套疊複髮後再行0.9％氯化鈉溶液灌腸複位術,診斷為繼髮性腸套疊(麥剋爾憩室2例,幼年性息肉1例,腸重複畸形2例,淋巴瘤2例,闌尾炎1例,腸粘連1例).結論 麥剋爾憩室、腸息肉及腸重複畸形是最常見的引起小兒繼髮性腸套疊的病理誘髮點,超聲對小兒腸套疊診斷的敏感性高,併且可在超聲鑑視下行0.9％氯化鈉溶液灌腸複位術,其複位效果優于X線空氣灌腸,操作者可實時進行超聲觀察,瞭解腸套疊的複位情況,充滿0.9％氯化鈉溶液的腸腔更利于超聲醫生觀察,及早髮現引起腸套疊的病理誘髮點,為繼髮性腸套疊的外科臨床治療提供重要的影像依據.
목적 탐토관장하소인장투첩적초성도상급초성인도하0.9％록화납용액관장대소인계발성장투첩적진단화치료개치.방법 회고성분석23례소인계발성장투첩병례자료,총결불동병인인기적계발성장투첩적초성도상특점.결과 맥극이게실8례,유년성식육4례,낭종형장중복기형4례,림파류3례,란미염2례,장점련2례.23례계발성장투첩균우수차초성검사명학장투첩진단,기중22례초성인도하0.9％록화납용액관장복위성공,1례복위실패.13례우수차관장진단위계발성장투첩(맥극이게실6례,유년성식육3례,장중복기형2례,림파류1례,란미염1례),9례장투첩복발후재행0.9％록화납용액관장복위술,진단위계발성장투첩(맥극이게실2례,유년성식육1례,장중복기형2례,림파류2례,란미염1례,장점련1례).결론 맥극이게실、장식육급장중복기형시최상견적인기소인계발성장투첩적병리유발점,초성대소인장투첩진단적민감성고,병차가재초성감시하행0.9％록화납용액관장복위술,기복위효과우우X선공기관장,조작자가실시진행초성관찰,료해장투첩적복위정황,충만0.9％록화납용액적장강경리우초성의생관찰,급조발현인기장투첩적병리유발점,위계발성장투첩적외과림상치료제공중요적영상의거.
Objective To discussion of secondary intussusception in children based on ultrasound image,and the diagnosis and the therapeutic value.Methods 23 cases of secondary intussusception in children by the ultrasound image were reviewed and pathogeny analyzed.Results Within this 23 cases of secondary intussusception in children:8 cases in 23 cases were caused by Meckel di-verticulum,4 cases were caused by juvenile polyps,4 cases were caused by intestinal duplication,3 cases were caused by intestinal lymphoma,2 were caused by appendicitis,and 2 cases were caused by intestinal adhesion.And 23 cases of them were all detected by ultrasound at the very first time.22 cases of 23 cases was operated by hydrostatic enema of ultrasonic monitoring treating intussusception successfully,and 1 failed.13 cases were confirmed as secondary intussusception after first enema (Meckel di-verticulum 6 cases,juvenile polyps 3 cases,intestinal duplication 2 cases,intestinal lymphoma 1,and appendicitis 1 cases).9 cases were operated by hydrostatic enema of ultrasonic monitoring treating intussusception again when palindromia happened,which were confirmed as secondary intussusception (Meckel di-verticulum 2 cases,juvenile polyps 1 cases,intestinal duplication 2 cases,intestinal lymphoma 2 cases,appendicitis 1 cases,and intestinal adhesion 1 cases).Conclusion Meckel di-verticulum,juvenile polyps and intestinal duplication are the most common pathologic lead points caused the secondary intussusception in children.The diagnosis of ultrasound is sensitive to children secondary intussusception,and hydrostatic enema of ultrasonic monitoring treating intussusception can be operated under ultrasonic monitoring,which has an even better result than air enema under X-ray.The situation of bowel,which is full of 0.9％ sodium chloride solution,gives operators a good effect of visual to find pathologic lead points.And that really helps to provide valuable image in accordance with clinical surgery therapy of secondary intussusception.
