彩色多普勒超声对急性小肠套叠患儿治疗时机及方案选择的评估价值

Evaluation of the selection of treatment time and plan for acute small bowel intussusception in children with color Doppler ultrasonography

目的分析彩色多普勒超声用于急性小肠套叠患儿对于治疗时机及方案选择的评估价值。方法急性小肠套叠患儿54例,其中23例手术治疗患儿作为手术组,31例自行复位患儿作为对照组。所有患儿均接受彩色多普勒超声检查,分析患儿超声表现特点,并比较2组患儿一般资料及超声检查结果。结果手术组患儿病程较长,血便比例高于对照组,差异均有统计学意义(P<0.05);手术组患儿腹部包块比例、病理性先驱物比例、套头外层肠壁厚度、套头长度、套头直径均明显高于对照组,肠壁内彩色血流信号比例低于对照组,差异均有统计学意义(P<0.05);手术组患儿多为继发性,1例伴小肠息肉,1例伴肠重复畸形,4例伴过敏性紫瘢,8例伴美克尔憩室,9例为原发性小肠套叠。结论行手术治疗的急性小肠套叠患儿具有外层肠壁水肿、套入部长、套头直径大以及肠壁内彩色血流信号较少等超声特点,彩色多普勒超声检查对于治疗时机及方案选择具有一定评估价值。

Objective To evalute of the selection of treatment time and plan for acute small bowel intussusception in children with color doppler ultrasonography. Methods For 54 patients with acute small bowel intussusception in our hospital ,23 patients undergoing surgical treatment were set as an operative group, while 31 self repositioning patients were as a control group. All children were examined by color Doppler ultrasound, and their ultrasonic manifestations were analyzed. Both groups were compared for general data and ultrasound examination results. Results The operative group showed remarkably longer course of treatmenl and higher bloody stool percentage than the control group (P < 0. 05). Furthermore ,marked increases in abdominal mass ratio, pathological precursor percentages, the outer diameter of the outer wall, the length and diameter of the sleeve were found in the operative group, compared with those of the control group, while marked decreases in the proportion of color flow signals in the intestinal wall were detected in the operative group, compared with those of the control group (P < 0. 05). Most of the children in the operation group suffered from secondary small bowel intussusception, including 1 case of intestinal polyp, 1 case of intestinal duplication malformation, 4 cases of allergic purpura, 8 cases of MecRel's diverticulum, and 9 cases of primary small bowel intussusception. Conclusions After surgical treatment, acute small bowel intussusception children are characterized in intestinal edema, long sheath in the outer sleeve, large diameter, and less color Doppler signals. Color Doppler ultrasound exami nation is useful for determining treatment time and plan.