超声在婴幼儿胃食管反流相关性疾病中的诊断价值及效能研究

Diagnostic value and efficacy of ultrasonography in infants with gastroesophageal reflux-related diseases

目的:探讨超声在婴幼儿胃食管反流相关性疾病中的诊断价值及效能.方法:选择2020年3月~2021年9月疑似婴幼儿胃食管反流相关性疾病患者2316例为对象,所有患儿均常规超声检查,并以临床最终检查结果作为"金标准",分析超声检查在婴幼儿食管反流疾病中的诊断价值.根据婴幼儿年龄将患者分为新生儿组、婴儿组及幼儿组,超声观察胃食管连接部位,并完成His角大小的测量;绘制ROC曲线,分析超声检测His在婴幼儿胃食管反流相关性疾病中的诊断效能.结果:2316例疑似婴幼儿胃食管反流相关性疾病患者经临床检查最终确诊1847例,确诊率为79.75%.超声检查最终确诊1759例,检查准确度为85.84%,诊断灵敏度为88.74%,特异度为74.41%,阳性预测值为93.18%,阴性预测值62.66%;超声下阳性婴幼儿His角高于阴性婴幼儿;婴幼儿不同年龄段His角比较无统计意义;ROC曲线结果表明:超声检测His角用于婴幼儿胃食管反流相关性疾病中AUC值为0.835,最佳截断值为102.22°时,诊断灵敏度为85.29%,特异度为80.51%.结论:超声用以婴幼儿胃食管反流相关性疾病中具有较高的检出率,超声下His角明显增大,能获得较高的诊断灵敏度与特异度.

Objective To investigate the diagnostic value and efficacy of ultrasound in the diagnosis of gastroesophageal re-flux-related diseases in infants and young children.Methods A total of 2316 patients with suspected gastroesophageal reflux-related diseases in infants and young children from March 2020 to September 2021 were selected as the subjects.All children underwent routine ultrasound examination,and the final clinical examination results were used as the“gold standard”to analyze the ultrasound Check the diagnostic value of esophageal reflux disease in infants and young children.According to the age of in-fants and young children,the patients were divided into neonatal group,infant group and young child group.The gastroesopha-geal junction was observed by ultrasound,and the angle of His was measured.The ROC curve was drawn to analyze the cor-relation between ultrasound detection of His in gastroesophageal reflux in infants and young children.Diagnostic performance in disease.Results 1847 cases of 2316 suspected infants with gastroesophageal reflux-related diseases were finally diagnosed by clinical examination,and the diagnosis rate was 79.75%.Ultrasound examination finally diagnosed 1759 cases,the inspec-tion accuracy was 85.84%,the diagnostic sensitivity was 88.74%,the specificity was 74.41%,the positive predictive value was 93.18%,and the negative predictive value was 62.66%;The angle was higher than that of the negative infants;the comparison of His angle in different age groups of infants and young children was not statistically significan.When the AUC value was 0.835 and the optimal cutoff value was 102.22°,the diagnostic sensitivity was 85.29%and the specificity was 80.51%.Conclusion Ultrasound has a high detection rate in infants and young children with gastroesophageal reflux-related diseases,and the His angle is significantly increased under ultrasound,which can obtain high diagnostic sensitivity and specificity.