腹部超声检查对新生儿坏死性小肠结肠炎的临床应用价值研究

目的:探究腹部超声检查对新生儿坏死性小肠结肠炎(NEC)的临床应用价值。方法:选取2009年1月-2016年12月我院收治116例患有NEC的新生儿作为本次研究的对象,依据修正Bell-NEC分级标准将之分为确诊组(n=50)和疑似组(n=66),再依据临床转归分为手术组(n=37)和内科治愈组(n=79),对比确诊组和疑似组的腹部超声与X线检查结果,以及内科治愈组和手术组的腹部超声与X线检查结果。结果:在确诊组和疑似组中,腹部超声对肠壁积气、门静脉积气的检出率均高于X线摄片(P0.05)。腹部超声还发现了肠道蠕动缓慢、肠道蠕动消失和腹腔积液;内科治愈组腹部超声对肠壁增厚、肠管扩张和腹腔积液的检出率低于手术组(P0.05);内科治愈组X线摄片对肠管扩张的检出率低于手术组(P0.05)。结论:腹部超声能够提高NEC的检出率,且对NEC的临床转归有较好的预测作用。

Clinical Value of Abdominal Ultrasonography in the Diagnosis of Neonatal Necrotizing Enterocolitis

ABSTRACT Objective: To explore clinical value of abdominal ultrasonography in the diagnosis of neonatal necrotizing enterocoli- tis(NEC). Methods: A total of 116 patients with NEC in our hospital from January 2009 to December 2016 were selected as the objects of this study. According to the modified Bell-NEC classification criteria,the patients were divided into diagnosis group(n=50) and suspected group(n=66). According to clinical outcome, the patients were divided into operation group(n=37)and medical cure group(n=79). The re- sults of abdominal ultrasound and X-ray examination were compared between the diagnosis group and the suspected group, and he results of abdominal ultrasound and X-ray examination were compared between the operation group and the medical cure group. Results: In the diagnosis group and the suspected group, the detection rate of abdominal ultrasound on abdominal wall gas and portal venous gas were higher than those of X-ray examination(P<0.05). Abdominal ultrasound also revealed bowel slow peristalsis, loss of peristalsis and seroperitoneum.The detection rate of abdominal ultrasound on bowel wall thickening, intestinal dilatation and seroperitoneum in medical cure group were lower than those in operation group(P<0.05). The detection rate of X-ray film on intestinal dilatation in medical cure group was lower than that in operation group(P<0.05). Conclusion: Abdominal ultrasonography can improve the detection rate of NEC, and has a better predictive effect on the clinical outcome of NEC.