新生儿坏死性小肠结肠炎X线诊断探讨

Investigation on Radiological Diagnosis of Neonatal Necrotizing Enterocolitis

笔者通过143例新生儿坏死性小肠结肠炎(NEC)的临床和X 线资料分析,着重讨论了几种主要X 线征象的诊断价值。动力性肠胀气虽非特异性征象,但对临床疑为NEC 而X 线仅示肠胀气者仍应予以足够重视并作紧密X 线随访。肠壁积气和门静脉积气是诊断NEC 的特异性征象,弥漫性肠壁积气和/或门静脉积气的出现是病情危重和预后较差的征兆.文中还提出了腹膜外积气和脾静脉积气两种新X 线征象,并对肠壁积气和粪气影的鉴别以及手术指征作了初步探讨。

The clinical and radiological fea-tures of 143 cases of neonatal necro-tizing enterocolitis(NEC)were analy-sed and the diagnostic importance ofsome X-ray findings was stressed.Al-though the functional bowel disten-tion is not a specific radiologic fin-ding,sufficient attention must be paidto it when the clinical manifestationsare suspicious of NEC,Follow up withsequential radiography is necessary.Intramural gas and portal venous gasare specific in diagnosis of NEC.Ge-neralized intramural and/or portelve-nous gas indicate poor prognosis.Twonew radiographic findings i.e.theextrapertoneal gas and splenic venousgas are presented.The differentiationof intramural gas from “fecal-gaspattern”and the indications for sur-gery are discussed as well.