新生儿坏死性小肠结肠炎X线诊断

X-ray diagnosis in neonatal necrotizing enterocolitis

目的:总结分析新生儿坏死性小肠结肠炎(NEC)的X线表现,提高对新生儿NEC早期病变的认识。方法:搜集经X线和/或临床手术病理证实的NEC病例52例,回顾性分析其临床及X线表现,对其孕周、出生体重与NEC发病关系进行分析;同时对52例病例的X线表现进行随访跟踪。结果:本组52例中首次摄片表现为典型NEC 28例,表现为早期NEC 13例,疑似早期NEC 11例。13例早期NEC二次复查痊愈7例,进展为典型NEC 4例,演变为肠道动力性异常2例。11例疑似早期NEC患儿第三次复查痊愈8例,进展为动力性梗阻3例,该3例第四次复查1例痊愈,2例出现典型NEC表现。结论:早产、低出生体重新生儿是NEC高危人群。X线早期诊断对指导临床治疗及预后评估具有重要价值。

[Abstruct]_Objective：To summarize the X-ray findings of 52 patients with neonatal necrotizing enterocolitis （NEC）in the early stage and to improve the diagnostic accuracy.Methods：52 patients with necrotizing enterocolitis were collected and analyzed retrospectively.All were confirmed by follow-up X-ray and/or by post-operative pathological results.All 52 cases were followed up and correlatively analyzed between clinical and X-findings with their gestational age,birth weight and inci-dence of NEC.Results：There were 28 patients showing typical NEC X-ray manifestations at their first visit,13 cases with manifestations at early stage,and 11 with suspected early NEC.For the 13 early NEC patients,7 of them recovered in sec-ond visit without positive findings,4 patients were found in progressing to typical NEC,and 2 cases developed as enteric dy-namic changes.From the 11 cases suspected with early NEC,eight were recovered in third follow-up X-ray,three cases e-volved as dynamic enteric obstruction.One of the three cases recovered and other two developed as typical NEC at the fourth follow-up.Conclusion：Premature and lower birth weight infants are of higher risks of suffering from NEC.It is im-portant to have early X-ray exam in terms of clinical treatments and prognosis prediction in those suspected with neonatal NEC.