儿童小肠套叠与大肠套叠临床特征及超声评价

Clinical features of small intestine and large intestine intussusception in children and their ultrasonic evaluation

  • 摘要: 目的 探讨儿童小肠套叠与大肠套叠临床特征及超声对不同肠套叠的评价作用。 方法 回顾分析227例肠套叠患儿的临床资料,超声检查共检测出238处肠套叠。根据临床特点、超声及空气灌肠影像学表现分为小肠套叠组(套叠122处)和大肠套叠组(套叠116处)。比较2组临床特征及超声声像图特征。 结果 小肠套叠患儿便血、腹块例数均少于大肠套叠患儿,差异有统计学意义(P<0.01)。小肠套叠组套叠外径、套叠长度均短于大肠套叠组,差异均有统计学意义(P<0.01);2组淋巴结肿大例数比较,差异无统计学意义(P>0.05)。小肠套叠空气灌肠患儿套叠长度长于自行缓解患儿,淋巴结肿大多于自行缓解患儿,差异均有统计学意义(P<0.01)。套叠外径临界值为2.15 cm时约登指数最大,筛检小肠套叠效果最好,此时灵敏度83.6%,特异度92.6%。 结论 超声对诊断小肠套叠与大肠套叠具有重要作用。

     

    Abstract: Objective To investigate the clinical features of small intestine intussusception and large intestine intussusception in children and evaluation of different intussusception by ultrasonography. Methods The data of 227 children with intussusception was retrospectively analyzed, with the number of 238 intussusception in total. According to clinical characteristics, ultrasound and air enema imaging findings, the patients were divided into small intestine intussusception group (112 intussusception) and large intestine intussusception group (116 intussusception). The clinical features and ultrasonographic features of the two groups were compared. Results The cases of blood in stool and abdominal mass of children with intestinal intussusception were significantly less than those of children with intestinal intussusception (P<0.01). The diameter and length of intussusception in small intestinal intussusception group were significantly shorter than those in large intestinal intussusception group (P<0.01). There was no significant difference in the number of lymph node enlargement between the two groups (P>0.05). The intussusception length of children with air enema was significantly longer, and the number of lymph nodes enlargement was significantly more than that of children with spontaneous remission (P<0.01). When the critical value of intussusception diameter was 2.15 cm, the Youden index was the largest and the screening effect of small intestine intussusception was the best, with the sensitivity of 83.6% and specificity of 92.6%. Conclusion Ultrasound plays an important role in the diagnosis of intestinal intussusception and large intestine intussusception.

     

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