婴儿肥厚性幽门狭窄的临床诊断与影像检查对照分析

Comparison of Clinical Diagnosis and Imaging Examination for Baby Hypertrophic Pyloric Stenosis

目的:探讨临床、超声及X线检查三者对肥厚性幽门狭窄(HPS)诊断的符合率。方法:通过手术证实的14例HPS的临床症状和体征、超声检查以及X线上消化道钡餐造影检查结果进行比较。结果:通过不含胆汁呕吐、右上腹深部触到橄榄状肿块等症状和体征的临床依据诊断HPS其符合率为42.9%。超声检查幽门肌厚度≥4mm、幽门管长度≥15mm的依据诊断HPS其符合率为85.7%。X线检查上消化道钡餐造影"幽门管延长"、"线样征"、"肩征"、"蕈征"等征象的依据可诊断HPS,符合率为92.9%。结论:通过临床、超声及X线检查对照分析,HPS的诊断以X线检查诊断率最高,其次为超声检查,仅靠临床对HPS的诊断符合率较低,但三者结合可以进一步提高HPS的诊断率。

Objective： To discuss the diagnostic coincidence rate of clinical symptoms and signs, supersonic examination and X-ray inspects which were used to diagnose the hypertrophic pyloric stenosis （HPS）. Methods： The clinical symptom and the body sign, supersonic examination result and X-ray on-line-the-digestive-tract barium meal radiography inspection result in 14 cases of HPS confirmed by the surgery operations were compared. Results： The diagnostic coincidence rates were as followed：42. 9% clinical symptoms and body signs, excluding bile vomiting and the Chinese olive shape of swell in the up right deep abdomen, 85. 7% in supersonic examination in term of that the pylorus is above 4mm in thickness, and the hypertrophic pyloric duct is 15ram in length, and 92. 9% in digestive tract barium meal radiography of X-ray inspection in the light of the ＂lengthened hypertrophic pyloric duct draft＂, ＂line type drafts＂, ＂shoulder drafts＂,＂gill fungus drafts＂and so on. Conclusion： The X inspection rate is the highst in diagnosis of HPS, and is followed by the supersonic inspection,and the inspection rate of clinical symptoms and signs is the lowest. The combined application of the three methods can greatly enhance the diagnostic rate.