腹部超声联合浅表超声对小儿肠套叠的诊断效能

Diagnostic efficacy of abdominal ultrasonography combined with superficial ultrasonography for intussusception in children

目的:分析腹部超声联合浅表超声对小儿肠套叠的诊断效能。方法:抽取2019年1月至2020年12月南阳市第一人民医院收治的疑似肠套叠患儿86例,均行腹部超声、浅表超声检查,以手术结果为"金标准",统计腹部超声、腹部超声联合浅表超声的诊断结果和诊断效能,分析不同类型肠套叠的诊断符合率。结果:86例疑似肠套叠患儿中,手术确诊阳性60例,阴性26例;腹部超声诊断出真阳性42例,真阴性17例;腹部超声联合浅表超声诊断出真阳性58例,真阴性21例。腹部超声联合浅表超声诊断的特异度、误诊率与腹部超声比较,差异未见统计学意义(P>0.05);腹部超声联合浅表超声诊断灵敏度(96.67%,58/60)、准确度(91.86%,79/86)高于腹部超声(70.00%,42/60;68.60%,59/86),漏诊率(3.33%,2/60)低于腹部超声(30.00%,18/60),P<0.05。腹部超声联合浅表超声诊断回盲肠肠套叠、小肠肠套叠的符合率与腹部超声比较,差异未见统计学意义(P>0.05);腹部超声联合浅表超声诊断结肠肠套叠符合比例(100.00%,6/6)、回结肠肠套叠符合率(96.77%,30/31)、总符合率(96.67%,58/60)高于腹部超声(16.67%,1/6;74.19%,23/31;70.00%,42/60),P<0.05。结论:腹部超声联合浅表超声诊断小儿肠套叠的灵敏度和准确度较高,可减少漏诊,能有效鉴别不同类型肠套叠,可为临床治疗疾病提供有力依据。

Objective To analyze the diagnostic efficacy of abdominal ultrasonography combined with superficial ultrasonography for intussusception in children.Methods A total of 86 children with suspected intussusception who were admitted to Nanyang First People's Hospital from January 2019 to December 2020 were selected,and all of them underwent abdominal ultrasonography and superficial ultrasonography examination.Taking the operation results as the gold standard,the diagnostic results and diagnostic efficacy of abdominal ultrasonography and combination of abdominal ultrasonography with superficial ultrasonography were counted.And the diagnostic coincidence rate of different types of intussusception were analyzed.Results Among the 86 children with suspected intussusception,60 cases were positive,and 26 cases were negative according to surgical diagnosis;42 cases were true positive,and 17 cases were true negative according to abdominal ultrasonography diagnosis;58 cases were true positive,and 21 cases were true negative according to abdominal ultrasonography combined with superficial ultrasonography.There was no significant difference in the specificity and misdiagnosis rate between abdominal ultrasonography combined with superficial ultrasonography and abdominal ultrasonography alone(P>0.05).The diagnostic sensitivity(96.67%,58/60)and accuracy(91.86%,79/86)of abdominal ultrasonography combined with superficial ultrasonography were higher than those of abdominal ultrasonography alone(70.00%,42/60;68.60%,59/86),and the missed diagnosis rate(3.33%,2/60)was lower than that of abdominal ultrasonography(30.00%,18/60),P<0.05.There was no significant difference in the coincidence rate between abdominal ultrasonography combined with superficial ultrasonography and abdominal ultrasonography alone in diagnosis of ileocecal intussusception and small bowel intussusception(P>0.05).The coincidence ratio in diagnosing colonic intussusception(100.00%,6/6)coincidence rate in diagnosing ileocolic intussusception(96.77%,30/31),and total coincidence rate(96.67%,58/60)of abdominal ultrasonography combined with superficial ultrasonography were higher than those of abdominal ultrasonography alone(16.67%,1/6;74.19%,23/31;70.00%,42/60),P<0.05.Conclusions Abdominal ultrasonography combined with superficial ultrasonography has a high sensitivity and accuracy in diagnosing of intussusception in children,which can reduce missed diagnosis,effectively identify types of intussusception,and provide a strong basis for clinical treatment of the diseases.