儿童颈静脉扩张症临床表现及误诊分析

Analysis of clinical manifestations and misdiagnosis of jugular phelebectasia in children

目的探讨儿童颈静脉扩张症的临床表现及误诊原因。方法回顾性分析21例颈静脉扩张症患儿临床表现,以及彩色多普勒超声检查特点,并与对照组21例无颈静脉扩张的儿童进行对比,总结其临床表现、诊断方法及误诊原因。结果研究组21例患儿临床表现主要为大声讲话、屏气时颈部隆起肿块,安静时消失,确诊前平均就诊2.4次,给予辅助检查1.9次。对照组21例儿童在大声讲话、屏气时无明显颈部肿块隆起。彩色多普勒超声检查研究组与对照组平静时颈静脉最大内径比较无统计学意义(P>0.05),大声喊叫或做Valsalva动作时两组颈静脉最大内径比较有统计学意义(P<0.05)。本组患儿均经彩色多普勒超声确诊。结论本病临床表现典型,正确的彩色多普勒超声检查是诊断本病的有效方法。临床上提高对本病的认识,可以减少误诊。

Objective To analyze the clinical manifestations and the cause of misdiagnosis of jugular phelebectasia in children.Methods From January 2006 to June 2013,21 cases of jugular phelebectasia in children were collected and reviewed.Their clinical manifestation ,diagnostic methods and the cause of misdiagnosis were analyzed.21 children without jugular phelebectasia were selected as control group.Results Their clinical manifestations showed a soft cystic cervical mass during Valsalva manoeuvre or loud speaking.All the cases visited other hospital 2.4 times averagely and received imaging exams 1 .9 times averagely before final diagnosis.There was no significant difference in the diameter of jugular vein between jugular phelebectasia patients and the control group during the resting state（P〉0.05）,however,the diameter of jugular vein were larger in jugular phelebectasia patients during Valsalva manoeuvre or load speaking （P〈0.05）.All the jugular phelebectasia were diagnosed by color Doppler ultrasonography.Conclusion The manifestation of jugular phelebectasia is typical.The effective method to diagnose jugular phelebectasia is color Doppler ultrasonography.Deepening the understanding of jugular phelebectasia could decrease the misdiagnosis.