CAJ | 학술논문

目的：探讨超声诊断新生儿环状胰腺的临床价值,分析漏诊及误诊的原因,旨在提高超声诊断该病的准确率。方法回顾性分析98例经消化道造影及手术证实为新生儿环状胰腺的临床资料,将术前超声检查的声像图表现与消化道造影及手术结果对比分析,对超声漏诊、误诊及诊断不明确的声像图进行深入研究,并总结该病的超声诊断要点。结果98例患儿中,超声正确诊断75例,诊断符合率为76.5%；漏诊18例,误诊5例,漏误诊率为23.5%。10例因同时合并其他先天性消化道畸形,忽略对胰腺的扫查而漏诊,5例因超声显示腹腔明显胀气而漏诊,3例因对该病认识不足而漏诊,5例误诊为十二指肠膜式狭窄或闭锁。结论超声对新生儿环状胰腺具有重要的诊断价值,为临床治疗提供诊断依据,可作为首选辅助检查。由于常合并其他先天性消化道畸形,且受腹腔气体干扰严重,容易发生漏诊及误诊,检查时需将新生儿梗阻的所有原因考虑在内,从而提高超声诊断的准确性。
목적：탐토초성진단신생인배상이선적림상개치,분석루진급오진적원인,지재제고초성진단해병적준학솔。방법회고성분석98례경소화도조영급수술증실위신생인배상이선적림상자료,장술전초성검사적성상도표현여소화도조영급수술결과대비분석,대초성루진、오진급진단불명학적성상도진행심입연구,병총결해병적초성진단요점。결과98례환인중,초성정학진단75례,진단부합솔위76.5%；루진18례,오진5례,루오진솔위23.5%。10례인동시합병기타선천성소화도기형,홀략대이선적소사이루진,5례인초성현시복강명현창기이루진,3례인대해병인식불족이루진,5례오진위십이지장막식협착혹폐쇄。결론초성대신생인배상이선구유중요적진단개치,위림상치료제공진단의거,가작위수선보조검사。유우상합병기타선천성소화도기형,차수복강기체간우엄중,용역발생루진급오진,검사시수장신생인경조적소유원인고필재내,종이제고초성진단적준학성。
Objective To investigate the clinical value of ultrasonic diagnosis for neonatal annular pancreas,analyze the reasons of missed diagnosis and misdiagnosis,and improve diagnostic accuracy of ultrasonography for this disease.Methods Clinical data of 98 newborns with annular pancreas confirmed by gastrointestinal contrast and surgery were analyzed retrospectively.Preoperative ultrasonogram were compared with the result of gastrointestinal contrast and surgery.Ultrasound images failed to be correctly dignosed were further studied to summarize diagnostic points for this disease.Results Among the 98 cases, 75 were correctly diagnosed by ultrasound with a diagnostic accordance rate of 76.5%,1 8 were missed diagnosed and 5 were misdiagnosed with a total misdiagnosis rate of 23.5%.Ten cases associated with other congenital gastrointestinal tract anomalies were missed diagnosed due to ignoring scanning pancreas.Five cases were missed diagnosed due to obvious intestinal cavity flatulence.Three cases were missed diagnosed due to lack of awareness of the disease.Five cases were misdiagnosed for duodenal stenosis or duodenal atresia.Conclusions Ultrasound has important diagnostic value for neonatal annular pancreas,providing the dignostic evidences for clinical treatment.Thus it can be used as the preferred auxiliary examination of the disease.Since annular pancreas is often accompanied by other gastrointestinal malformations and can be interfered by abdominal gas,missed diagnosis and misdiagnosis occurred easily.To improve the accuracy of ultrasonic diagnosis,all causes of neonatal gastrointestinal tract obstructions should be considered during the examination.