儿童先天性幽门肥厚狭窄上消化道造影的诊断价值

Diagnostic value of upper digestive tract radiography in children with congenital hypertrophic pyloric stenosis

目的:探讨儿童先天性幽门肥厚狭窄的上消化道造影诊断.方法:采取回顾性方法对武汉市妇女儿童医疗保健中心2012-01/2014-01接收治疗的88例先天性幽门肥厚狭窄患儿的临床资料进行分析,所有患儿术前均进行上消化道造影检查,分析88例患儿的上消化道造影的影像学表现.结果:造影检查结果显示,88例患儿中有40(45.45%)例患儿为肩样征、16(18.18%)例患儿为乳头征、40(45.45%)例患儿为线样征、20(22.72%)例患儿为菌伞征、29(32.95%)例患儿为鸟嘴征、30(34.09%)例患儿为双轨征.造影检查结果显示患儿幽门管直径为15.1 mm±0.80 mm,幽门管长度为22.1 mm±2.04 mm,幽门肌厚度为5.2 mm±0.61 mm.手术测值显示患儿幽门管直径为15.5 mm±0.71 mm,幽门管长度为23.1 mm±2.15 mm,幽门肌厚度为4.7 mm±0.69 mm.比较差异具有统计学意义(P<0.05).结论:上消化道造影手段对儿童先天性幽门肥厚狭窄有十分重要的临床意义,其为较可靠的影像学检查方法.

AIM： To evaluate the diagnostic value of upper digestive tract radiography in children with congenital hypertrophic pyloric stenosis. METHODS： Clinical data for 88 children with congenital hypertrophic pyloric stenosis treated at Wuhan Medical Care Center for Women and Children Hospital from January 2012 to January 2014 were retrospectively analyzed. Upper digestive tract radiography was performed preoperatively in all the patients. RESULTS： Of the 88 children, 40 （45.45%） had shoulder-like symptoms, 16 （18.18%） had nipple sign, 40 （45.45%） had line-like sign, 20 （22.72%） had pileus sign, 29 （32.95%） had beak sign, and 30 （34.09%） had tram line sign. Upper digestive tract radiography showed that pyloric duct diameter was 15.1 mm ＋ 0.80 mm, pyloric duct length 22.1 mm± 2.04 mm, and pyloric muscle thickness 5.2 mm± 0.61 mm. Intraoperatively measured pyloric tube measured pyloric duct diameter was 15.5 mm ± 0.71 mm, pyloric duct length 23.1 mm ± 2.15 mm, and pyloric muscle thickness 4.7 mm ±0.69 mrn, which were significantly different from those measured by radiography （P 〈 0.05）. CONCLUSION： Upper gastrointestinal tract radiography has very important diagnostic significance in children with congenital hypertrophic pyloric stenosis.