急诊彩色多普勒超声对小儿急性肠套叠的诊断思路与价值研究

Diagnostic ideas and value research of emergency color Doppler ultrasound in children with acute intussusception

目的:探讨超声医生掌握小儿急性肠套叠的诊断思路及临床应用价值。方法:收集弋矶山医院2016年10月—2017年10月经空气灌肠复位或手术确诊的急性肠套叠患儿46例,回顾性分析肠套叠声像图特征,总结不同类型肠套叠的超声诊断思路。结果:46例肠套叠患儿中44例超声诊断正确,2例误诊,诊断符合率约95.6%,诊断正确的44例中,回盲型27例、回结型11例、回回结型2例、小肠型4例;小肠型中包括暂时性肠套叠2例、继发性肠套叠1例、肠坏死1例;44例肠套叠中,43例套叠部肠壁检测出血流信号,1例未探及明显血流信号。40例经X线空气灌肠复位成功,1例谨慎空气灌肠复位失败,后行手术复位,1例行部分肠切除术,2例住院观察期间自行解套复位。结论:急诊超声医生对肠套叠清晰准确的诊断思路及彩色多普勒超声的优点在临床早发现早治疗及患儿的预后评估等方面具有很好的应用价值。

Objective To investigate the diagnostic ideas and clinical application value of acute intussusception in children by doctors of ultrasound. Methods 46 cases of acute intussusception between October 2016 and October 2017 in Yijishan hospital were confirmed by air enema reset or surgery diagnosis, retrospective analysis of characteristics of ultrasound image of intussusception, and summarize the ultrasonic diagnosis ideas of different types of intussusception. Results Among46 cases of intussusception, 44 cases were diagnosed correctly by ultrasonography, 2 cases of misdiagnosis, the diagnostic accordance rate was about 95.6%, the correct diagnosis in 44 cases, 27 were ileum-caecal type, 11 were ileum-colon type,2 were ileum-ileum-colon type, and 4 were small intestine type;In the small intestinal type, 2 cases were temporary intussusception, 1 cases were secondary intussusception and 1 cases of intestinal necrosis;In 44 cases of intussusception,43 cases of bleeding signals detected by sleeve wall, and 1 cases without significant blood flow signals. 40 cases of X-ray air enema reduction were successful, 1 case failed by caution air enema reduction, then operated by surgical reduction,1 patient underwent partial intestinal resection, 2 cases were self reattached during the hospital observation. Conclusion The clear and accurate diagnostic ideas of intussusception by the emergency ultrasound doctor and the advantages of color Doppler ultrasound are of great application value for early detection, early treatment and prognosis evaluation of children.