小儿肠系膜淋巴结炎诊断中高频超声的应用及临床研究

Analysis on the application and clinical significance of high-frequency ultrasonography in the diagnosis of mesenteric lymphadenitis of children

目的:探讨小儿肠系膜淋巴结炎诊断中高频超声的应用及临床意义。方法:选取医院收治的154例小儿肠系膜淋巴结炎疑似患儿,均行高频超声诊断,并以病理结果为“金标准”,比较不同检测部位肿大淋巴结比例、治疗前后肠系膜淋巴结纵横径比与血流分级以及诊断结果。结果:病理学诊断154例患儿,脐周、脐周及右下腹、右下腹、左上腹以及脐周及左上腹见肿大淋巴结比例分别为80.5%、13.0%、5.2%、0.0%和1.3%;治疗后与治疗前比较,患者脐周、脐周及右下腹以及右下腹各部位淋巴结最大径明显降低,差异有统计学意义(t=75.082,t=19.263,t=9.809;P<0.05),脐周、脐周及右下腹以及右下腹淋巴结纵横径比明显降低,差异有统计学意义(t=5.561,t=6.000,t=4.708;P<0.05);治疗后Ⅱ级与Ⅲ级血流分级患儿占比明显降低,差异有统计学意义(x^(2)=11.843;P<0.05);治疗后与治疗前比较,患者肠系膜淋巴结横径与纵径均明显减小,差异有统计学意义(t=16.754,t=15.322;P<0.05);高频超声诊断肠系膜淋巴结炎阴性与阳性例数分别为6例和144例,高频超声诊断的准确率、特异度及灵敏度分别为97.4%、75.0%和98.6%,高频超声与病理诊断准确率、特异度及灵敏度相比,差异无统计学意义。结论:高频超声是一种准确率高、重复性强的诊断方式,可对小儿肠系膜淋巴结炎疑似患儿进行准确诊断,为临床首选诊断方法,可为患儿临床治疗提供理论依据。

Objective:To investigate the application and clinical significance of high-frequency ultrasonography in the diagnosis of mesenteric lymphadenitis of children.Methods:A total of 154 pediatric suspected mesenteric lymphadenitis patients admitted to hospital were selected and underwent high-frequency ultrasonography,and the pathological results were taken as the“gold standard”.The proportion of enlarged lymph nodes,the ratio of transverse and lengthways diameter of mesenteric lymph nodes before and after treatment,blood flow grading,and diagnostic results were compared at different detection sites.Results:As the pathological results of 154 cases,the proportions of enlarged lymph nodes around navel,navel and right lower abdomen,right lower abdomen,left upper abdomen,navel and left upper abdomen were 80.5%,13.0%,5.2%,0.0%,1.3%,respectively.Compared with that before treatment,the maximum diameters of lymph nodes around the navel,around the navel and right lower abdomen,and right lower abdomen decreased significantly after treatment(t=75.082,t=19.263,t=9.809,P<0.05),and the ratios of transverse and lengthways diameter of mesenteric lymph nodes around navel,navel and right lower abdomen,and right lower abdomen decreased significantly(t=5.561,t=6.000,t=4.708,P<0.05),respectively.After treatment,the proportion of patients with blood flow grades of grade Ⅱ and Ⅲ decreased significantly(x^(2)=11.843,P<0.05).Compared with that before treatment,the transverse and lengthways diameters of mesenteric lymph nodes of patients decreased significantly after treatment(t=16.754,t=15.322,P<0.05).The positive and negative numbers of mesenteric lymph nodes were 6 cases and 144 cases as high-frequency ultrasonography,respectively.And the accuracy,specificity and sensitivity of the diagnosis of high frequency ultrasonography were 97.4%,75.0%and 98.6%,respectively.The differences of accuracy,specificity and sensitivity between high-frequency ultrasonography and pathological diagnosis were no significant.Conclusion:High-frequency ultrasonography is a highly accurate and strongly repeatable diagnostic method,which can accurately diagnose suspected patients with mesenteric lymphadenitis.It is the first choice for clinical diagnosis,and it can provide more effective theoretical basis for clinical treatment of children.