摘要
目的 为小儿肠套叠能否进行空气整复应用彩色多普勒检测探索可行性指标。方法 对123例肠套叠在二维超声的基础上进行彩色多普勒血流显像处理,详细记录水肿肠壁厚度,肠系膜动脉内血流峰速(PSV)及阻力指数(RI),并进行医学统计学处理。结果 肠套叠空气整复成功与否,与患儿性别及肠套叠部位无明显关系,与水肿肠壁厚度,PSV及RI有关。整复成功组水肿肠壁厚度:0.82±0.29(cm),PSV:21.23±3.72(cm/s),RI:0.61±0.08;失败组水肿肠壁厚度:1.49±0.31(cm),PSV:32.30±5.43(cm/s),RI:0.87±0.12。两组比较,三项指标P值均<0.001。空气整复可行性标准:当水肿肠壁厚度<1.11(cm),PSV<24.95(cm/s),RI<0.69时可空气整复,当水肿肠壁厚度在1.11-1.49(cm),PSV在24.95-32.30(cm/s),RI在0.69-0.87范围时,可空气整复但需谨慎。当水肿肠壁厚度>1.49(cm),PSV>32.30(cm/s),RI>0.87时不可空气整复,否则有肠穿孔的危险。结论 彩色多普勒可行性标准对正确选择患儿肠套叠空气整复或手术治疗具有很高的指导价值。
Objective To find out a set of applicable index for air enema applied to infantile intussusception detected by color Doppler flow imaging (CDFI). Methods One hundred and twenty three cases of infantile intussusception diagnosed by 2D ultrasound were examined with CDFI.The data including thickness of hydropic intestinal wall peak systolic velocity (PSV) and resistance index (RI) of mesenteric artery were gathered and analyzed statistically. Results Success of air enema was more related to the thickness of hydropic intestinal wall,arterial resistance index rather than the gender or the region of intussusception. For successful group,the thickness of hydropic intestinal wall:0.82±0.29 (cm), PSV:21.23±3.72(cm/s), RI: 0.61±0.08. For unsuccessful group, the thickness of hydropic intestinal wall: 1.49±0.31(cm), PSV:32.30±5.43 (cm/s), RI:0.87±0.12. Compared with each other for three index, value was P less than 0.001. The practical standard for air enema was: the thickness of hydropic intestinal wall<1.11cm, PSV<24.95 (cm/s), RI<0.69. When the thickness of hydropic intestinal wall was 1.11-1.49(cm), PSV 24.96-32.30(cm/s),RI 0.69-0.87,the patient still could be taken air enema therapy, but the operator should be very careful. When the thickness of hydropic intestinal wall>1.49 (cm), PSV>32.30 (cm/s), RI>0.87, air enema therapy could not be used to avoid intestinal perforation. Conclusion CDFI is highly valuable in selecting air enema therapy or surgical operation of patients with intussusception.
出处
《上海医学影像》
2004年第2期94-96,共3页
Shanghai Medical Imaging
