新生儿急性坏死性小肠结肠炎的X线临床诊断分析

Clinical Diagnosis and Analysis of X-ray in Neonatal Acute Necrotizing Enterocolitis

目的分析新生儿急性坏死性小肠结肠炎的X线临床诊断价值。方法选取我院收治的42例新生儿急性坏死性小肠结肠炎患儿作为研究对象,对其临床资料进行回顾性分析,所有患儿均行X线检查,观察其临床表现,评价其诊断的准确率。结果 (1)早期X线表现:以动力性肠梗阻为主,肠曲充气多,均存在不同程度的肠道扩张,肠曲充气不佳7例,肠曲内小液气平面9例,肠壁变厚、内壁模糊21例;肠壁囊样积气6例,胃肠变大33例,结肠中无气体或仅有少许气体39例。(2)复X线表现:新增肠壁囊样积气9例,线样积气4例,肝门静脉积气2例,气腹1例,液气腹1例,肠气恢复正常18例。(3)诊断符合率:与最终诊断结果,X线临床诊断结果完全准确,符合率为100%。(4)病情转化:给予多巴胺联合酚妥拉明治疗后,痊愈30例,好转11例,死亡1例。结论新生儿急性坏死性小肠结肠炎的发病率高,进展快,预后差,其临床表现不典型,X线临床诊断的准确率较高,对明确疾病进展以及治疗效果评估均具有重大意义。

Objective To analyze the value of X-ray diagnosis of neonatal acute necrotizing. Methods 42 children of neonatal acute necrotizing enterocolitis in our hospital were taken as the research object, the clinical data were retrospectively analyzed. All patients underwent X-ray exanfination, the clinical manifestation was observed and its diagnostic accuracy was evaluated. Results （ 1 ） The early X-ray manifestations with intestinal obstruction, there were many pwgmatic inflatable, long tract dilation, 7 cases of poor pwganatic inflatable, ptygrnafic small fluid level in 9 cases, intestinal wall thickening, 21 cases of intestinal wall blurred, cystic pneumatosis in 6 cases. The big change of 33 cases gastrointestinal, colon without gas or only a little gas in 39 cases. （ 2 ） In X-ray finding： new intestinal cystic pneumatosis in 9 cases, line pneumatosis in 4 cases, hepatic portal venous gas in 2 cases, 1 case ofpneumoperitoneum, 1 case of intestinal gas liquid pneumoperitoneun~, 18 cases returned to normal. （ 3 ） Diagnosis coincidence rate： with the final diagnosis result, the X-ray diagnosis result is completely accurate, the coincidence rate was 100%. （ 4 ） The condition of transforuaation： dopamine combined phentolamine treatment, 30 cases were cured, 11 cases improved, 1 case of death. Conclusion The incidence of neonatal acute necrotizing enterocolitis rate, apid progression, poor prognosis, atypical clinical manifestation, clinical X-ray diagnosis accuracy rate is higher, which is of great significance to explicitly evaluate disease progression and treatment effect.