婴幼儿急性阑尾炎超声图像特征及检查要点分析

Analysis of ultrasound image characteristics and main points of examination in infants with acute appendicitis

目的:探讨婴幼儿急性阑尾炎超声图像特征及检查要点,以提高超声诊断率。方法:回顾分析2015年2月—2020年2月我院26例婴幼儿急性阑尾炎患者,总结其超声表现及各类型超声图像特征,并结合婴幼儿急性阑尾炎的特点,探讨超声检查的要点问题。结果:26例婴幼儿急性阑尾炎中,急性单纯性阑尾炎11例,超声表现典型、诊断正确者9例,超声诊断符合率仅为81.82%;化脓性阑尾炎9例,有8例超声表现典型,诊断正确,符合率约88.89%;坏疽性阑尾炎和阑尾脓肿各3例,超声检查均诊断正确,符合率均为100%。结论:超声技术是诊断婴幼儿急性阑尾炎的重要手段,检查中可能会受到阑尾炎类型的限制、肠道气体的干扰,也会受到患儿不能配合检查以及病史叙述不清的影响。解决上述问题的关键在于,检查者要熟悉各种类型阑尾炎的病理及声像图特征,检查时要做到观察认真细致、灵活运用检查技巧与手法,将有助于提高婴幼儿急性阑尾炎的检出率和正确诊断率。

Objective To explore the ultrasonic image characteristics and inspection points of acute appendicitis in infants and young children,in order to improve the ultrasonic diagnosis rate.Methods From February 2015 to February 2020,We reviewed and analyzed 26 cases young children,summarized the ultrasonic features and various types of ultrasonic image characteristics,and combined with the characteristics of acute appendicitis in infants and young children,to explore the key issues of ultrasonic examination.Results Among 26 cases of acute appendicitis in infants,11 cases were acute simple appendicitis,9 cases had typical ultrasonic appearance,the ultrasonic diagnosis was correct,the coincidence rate of ultrasonic diagnosis was only 81.82%,9 cases were suppurative appendicitis,8 cases had typical ultrasonic appearance,the diagnosis was correct,the coincidence rate was about 88.89%.3 cases of gangrenous appendicitis and 3 cases of appendiceal abscess were diagnosed correctly by ultrasonography.The coincidence rate was about 100%.Conclusion Ultrasound is an important diagnostic method for acute appendicitis in infants and young children,which may be limited by the type of appendicitis,the interference of intestinal gas,and the children's failure to cooperate with the examination and unclear history.The key to solving the above problems is that the examining doctor should be familiar with the characteristics of the Sonogram of various types of appendicitis,and make careful observation and use the examining skills and techniques flexibly during the examination,it will improve the detection rate and correct diagnosis rate of appendicitis.