彩色多普勒超声在小儿肠套叠诊治中的应用

Application of color Doppler ultrasonography in diagnosis and treatment of intussusception in childen

目的探讨彩色多普勒超声诊断小儿肠套叠的作用及其对氯化钠注射液灌肠复位的监视作用。方法选取63例有非手术复位指征的小儿肠套叠患儿，均行彩色多普勒超声诊断，并对确诊患儿在彩色多普勒超声监视下行氯化钠注射液灌肠复位，统计其诊断及复位结果。结果63例患儿均经彩色多普勒超声诊断确诊，且横切面均表现为“同心圆”征，纵轴呈“套管”征。发病1～24h且血流信号为2—3级患儿复位成功率高于发病24～48h且血流信号为1～2级、发病24～48h且血流信号为0～1级患儿，差异有统计学意义（P〈0．05）；复位成功患儿血流峰速及阻力指数均明显高于复位失败患儿，差异有统计学意义（P〈0．05）。结论彩色多普勒超声诊断小儿肠套叠效果显著，且在其监视下行氯化钠注射液灌肠复位成功率较高。

Objective To investigate the effect of color Doppler ultrasonography on diagnosis of intussusception and the surveillance effect on saline enema reduction in children. Methods Sixty-three patients with intussusception but no indicator of reduction operation underwent color Doppler ultrasound for detection; and saline enema reduction guided by color Doppler ultrasound was performed in confirmed children; the resuits of diagnosis and reduction operation were recorded and analyzed. Results Sixty-three patients confirmed by color Doppler uhrasonography presented concentric circle sign in cross-section, and ＂sleeve＂ sign in the vertical axis. The success rate of enema reduction in children with 1 -24 h course of disease and 2 -3 grade blood flow signal was higher than that in children with 24 -48 h course of disease and 1 -2 grade blood flow signal, and children with 24 - 48 h course of disease and 0 - 1 grade blood flow signal, the differences were statistically significant （P 〈0. 05） ; peak flow velocity and resistance index in children with successful reduction were significantly higher than those in children with reduction failed, the differences were statistically significant （P 〈 0. 05）. Conclusions Color Doppler ultrasonography is effective in diagnosis of intussusception in children, under which success rate of saline enema reduction is higher.