超声评估胆汁性呕吐婴儿上消化道的价值

发布时间：2018-03-11 06:06

本文选题：婴儿胆汁性呕吐　切入点：肠旋转不良　出处：《中山大学学报(医学科学版)》2015年04期 　论文类型：期刊论文

【摘要】：【目的】探讨超声评估胆汁性呕吐婴儿上消化道的价值,并与X线上消化道造影检查(UGI)比较。【方法】对37例以胆汁性呕吐为主要表现的患儿进行了腹部超声检查,其中14例同时接受了UGI,23例同时接受了腹平片检查。以手术或随访结果作为最终诊断的参考标准,总结各类梗阻的超声表现,并将超声结果与其他影像学结果关联分析,取α=0.05。【结果】23例经(62.2%)经手术证实存在消化道器质性病变,另14例经随访未发现消化道器质性病变。超声发现20例存在上消化道梗阻,其敏感性、特异性和准确率分别为95%(19/20),76.5%(13/17),86.5%(32/37)。UGI判断梗阻的敏感性,特异性和准确率分别为80%(8/10),75%(3/4)和78.6%(11/14),与超声(85.7%,12/14)比较差异无统计学意义(P=0.635)。但是,超声(100%)和UGI(75%)判断肠旋转不良差异有统计学意义(P=0.041)。【结论】超声评估婴儿上消化道梗阻的能力至少不差于UGI,在诊断肠旋转不良的价值优于UGI。
[Abstract]:[objective] to evaluate the value of ultrasonography in evaluating upper digestive tract in infants with bile vomiting, and to compare it with UGI. [methods] abdominal ultrasonography was performed in 37 children with bile vomiting. Among them, 14 cases received UGIV examination at the same time and 23 cases received abdominal plain film examination. The results of operation or follow-up were used as the reference criteria for the final diagnosis, and the ultrasonographic findings of various types of obstruction were summarized, and the results of ultrasound were correlated with other imaging results. [results] 23 cases were proved by operation to have organic lesions of digestive tract, 14 cases had no organic lesions of digestive tract after follow up, 20 cases were found to have upper digestive tract obstruction by ultrasound, and the sensitivity was higher than that of other cases. The specificity and accuracy were 95 / 20 / 76. 5 / 13 / 17 / 86.5 and 32 / 37 / 37, respectively. The specificity and accuracy of UGI were 80 / 10 / 7575 / 4) and 78. 6% / 1114 / 14, respectively. There was no significant difference compared with ultrasound 85.712 / 14. [conclusion] the ability of ultrasound to evaluate the upper gastrointestinal obstruction in infants is at least no worse than that of UGI, and the value of diagnosing intestinal malrotation is better than that of UGI.
【作者单位】：中山大学附属第一医院超声科超声诊断与介入超声研究所;中山大学附属第一医院放射科;
【基金】：国家自然科学基金(81371555)
【分类号】：R445.1;R725.7

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