高频超声诊断新生儿十二指肠梗阻性疾病的价值

Value of high frequency ultrasound in diagnosis of duodenal obstruction in neonates

目的探讨高频超声在新生儿十二指肠梗阻性疾病诊断中的价值。方法回顾性分析113例新生儿十二指肠梗阻性疾病的超声检查结果、临床资料及术后病理结果。结果113例经手术证实为十二指肠梗阻的病例中，高频超声诊断正确106例，诊断率为93．81o．4（106／113）。其中肠旋转不良、十二指肠膜式狭窄、十二指肠闭锁、环状胰腺的超声诊断率分别为96．83％（61／63）、93．55％（29／31）、80．00％（4／5）、85．71％（12／14）。同时，92例超声提示梗阻部位与术中所见一致，超声对梗阻部位的诊断率为81．42％（92／113）。结论高频超声在新生儿十二指肠梗阻病因诊断及梗阻部位判断中有重要价值，可作为新生儿十二指肠梗阻性疾病的首选检查方法。

Objective To evaluate the clinical significance of high frequency ultrasound in the diagnosis of duodenal obstruction in neonates. Methods Ultrasonography, clinical data and etiological diagnoses of the operation in 113 neonates with duodenal obstruction were reviewed retrospectively. The digestive tract,including stomach, duodenum,jejunoileum and colon, were examined in all patients with 8- 12 MHz linear transducer before operation. Results In the 113 neonates with duodenal obstruction,63 cases were diagnosed intestinal malrotation, 31 cases duodenal stenosis, 14 cases annular pancreas, and 5 cases duodenal atresia. One hundred and six cases were diagnosed as duodenal obstruction by ultrasound,of which intestinal malrotation in 61 cases, duodenal stenosis in 29 cases, duodenal atresia in 4 cases, and annular pancreas in 12 cases. The diagnostic rate was 93.81% （106/113 cases）,96.83% （61/63 cases）, 93.55% （29/31 cases）, 80. 00% （4/Scases） and 85.71% （12/14 cases）, respectively. The location of obstruction diagnosed by ultrasound was coincident with the operation in 92 cases, with a diagnostic rate of 81.42 % （92/ 113）. Conclusions High frequency ultrasound plays an important role in diagnosing the causes and location of duodenal obstruction. It can be used as the first choice of examinal methods for the neonates with duodenal obstruction.