婴幼儿小肠扭转的早期诊断(附22例分析)

Early Diagnosis of Infantile Intestinal Volvulus(22 Cases Analysis)

目的分析婴幼儿肠扭转肠坏死的病变特点。方法收集近3年经手术和尸检证实的22例肠扭转病例.就其临床及X线检查和表现进行分析研究。结果22例中18例腹部X线检查有阳性发现,4例腹部阳性稀少征,阳性率为81.8%。20例接受手术治疗,证实单纯小肠扭转12例,合并肠坏死10例。治愈17例,死亡5例。结论本病的临床特点是:发病急,变化快,肠鸣音减弱或消失,早期的血便及中毒性休克;X线检查因其快捷方便.立卧位片可提供更多的信息.目前在婴幼儿小肠扭转中为首选及唯一的检查方法;短时间的腹水征是肠坏死的危险信号.腹部阳性稀少征是小肠全部或大部扭转的危险信号;提高影像科及临床医生对本病的认识是早期诊断的关键。

Objective To analysis feature of pathologic changes for infantile intestinal volvulus. Methods 22 cases of intestinal volvulus confirmed from postmortem examination were studied during recently 3-year operative infants,according to clinical as well as X-ray film sign,we analyzed and researched their outcome. Results Of 22 cases,18 cases abdomen X-ray examination showed positive findings,4 cases abdomen positive rare sign,positive rate was 81.8%,20 cases of them recived operation therapy,comfirmed 12 cases were simple intestianl volvulus,10 cases complicated with intestinal necrosis,10 cases healing,5 cases died. Conclusion Clinical features of the disease were as followed;acute attack,apostasis,gurgling sound weaken or disapper, early hemofaces and toxic shock.At present,choice of first and only examination way of infantile intestinalolvulus is X-ray examination,because the method rapid,convenient,and stand up film can provide much information,hydroperitoneum in short period is dangerous sign of intestinal necrosis,abdomen positive rare sign is dangersous sign of total or most intestinal volvulus.So that,raise imaging technique as well as clinical doctors early diagnostic level are keys for therapy of the disease.