摘要
目的:探讨高频超声联合术中腔内超声造影在小儿急性阑尾炎内镜下逆行阑尾炎治疗术(Endoscopic retrograde appendicitis therapy,ERAT)中的应用及疗效评估。方法:选取我院2019年1月—2020年12月接收的200例阑尾炎患儿,按年龄将患儿分为学龄前组(<6岁)和学龄组(≥6岁),治疗前超声检查测量阑尾外径、阑尾壁、肌层及黏膜层厚度,并记录阑尾腔内情况,所有患儿ERAT均在高频超声实时监测引导下进行,术中高频超声分别探查阑尾各项指标并记录,进一步联合应用术中腔内超声造影观察阑尾腔内冲洗情况,实时精准指导手术。治疗后1~2 d再次分别行高频超声检查评估患儿阑尾各参数情况。回顾性分析对比两组患儿治疗前后阑尾各参数,并随访其治疗后复发情况。结果:共有183例患儿ERAT操作顺利完成,成功率约为91.5%。在学龄前组,术前超声评估阑尾腔粪石、粪渣与内镜所见符合率明显高于学龄组(85.71%vs.67.81%,P<0.05)。两组患儿的阑尾黏膜层厚度治疗前后对比,均有显著性差异(学龄前组:(0.09±0.04)cm vs.(0.10±0.08)cm,P<0.05;学龄组:(0.09±0.03)cm vs.(0.10±0.07)cm,P<0.05);而两组患儿的阑尾外径、阑尾壁及肌层厚度治疗前后比较均无明显统计学差异。治疗后两组患儿腹痛症状即刻显著缓解,白细胞计数基本恢复正常,较ERAT前均有显著性差异(P<0.05)。结论:高频超声引导ERAT实时便捷,术中联合阑尾腔内超声造影可确保冲洗效果,提高治愈率,治疗小儿急性阑尾炎安全有效。
Objective:To evaluate the application and efficacy of high frequency ultrasound combined with intraoperative intracavitary contrast-enhanced ultrasound in the endoscopic retrograde appendicitis therapy(ERAT)of children with acute appendicitis.Methods:A total of 200 children with appendicitis in our hospital from January 2019 to December 2020 were selected and divided into preschool group(<6 years old)and school-age group(≥6 years old)according to their age.The outer diameter of the appendix,the thickness of the appendix wall,muscle layer and mucosal layer were measured by ultrasound before treatment,and the conditions in the appendix cavity were recorded.ERAT was conducted in all children under the guidance of real-time monitoring by high-frequency ultrasound.Intraoperative high-frequency ultrasound was used to explore and record various indicators of the appendix,and intraoperative contrast-enhanced ultrasound was further combined to observe the intraoperative irrigation of the appendiceal cavity,so as to provide real-time and accurate guidance for surgery.High-frequency ultrasonography was performed again 1~2 days after treatment to evaluate the appendiceal parameters.The appendiceal parameters of the two groups before and after treatment were retrospectively analyzed and compared,and the recurrence after treatment was followed up.Results:A total of 183 children underwent endoscopic treatment successfully,with a success rate of about 91.5%.In the preschool group,the coincidence rate of preoperative ultrasonographic evaluation of fecalith,fecal residue and endoscopy was significantly higher than that of the school-age group(85.71%vs.67.81%,P<0.05).There were significant differences in the thickness of appendiceal mucosa between the two groups before and after treatment(preschool group:(0.09±0.04)cm vs.(0.10±0.08)cm,P<0.05;school-age group:(0.09±0.03)cm vs.(0.10±0.07)cm,P<0.05);There were no significant differences in the outer diameter of appendix,intestinal wall and muscle layer between the two groups bef
作者
郭晓亚
李菁华
杨一林
曾令超
王春晖
杨瑞静
GUO Xiao-ya;LI Jing-hua;YANG Yi-lin;ZENG Ling-chao;WANG Chun-hui;YANG Rui-jing(Tangdu Hospital of Air Force Military Medical University,Xi’an 710038,China)
出处
《中国临床医学影像杂志》
CAS
CSCD
2022年第12期859-862,868,共5页
Journal of China Clinic Medical Imaging
基金
空军军医大学第二附属医院科技创新发展基金(2019LCYJ007)。
关键词
阑尾炎
儿童
超声检查
Appendicitis
Child
Ultrasonography
