遇建东

[摘要] 目的 分析超声检查对小儿肠重复畸形的初步诊断价值。 方法 回顾性收集2018年2月至2020年3月我院收治的32例小儿肠重复畸形患儿的临床资料，所有患儿均在术前行超声检查，以术后病理结果为金标准，统计术前超声检查诊断的符合率，并分析超声图像特点。 结果 32例经术后病理证实的肠重复畸形患儿中，术前超声检查诊断为肠重复畸形28例，误诊2例，漏诊2例，诊断符合率、误诊率、漏诊率分别为87.50%（28/32）、6.25%（2/32）、6.25%（2/32）。病变部位：小肠20例（71.43%）、結肠6例（21.43%）、空肠2例（7.14%）。病变形态：囊肿型20例（71.43%）（腔外型16例，腔内型4例）、管状型8例（28.57%）。合并症：合并肠套叠1例、合并肠梗阻2例、合并感染3例、合并肠扭转及肠坏死1例、合并肠穿孔1例、合并消化道出血8例。 结论 超声检查检出率及准确性较高，且操作简便、无创、经济，可作为小儿肠重复畸形术前初步诊断的首选方法。

[关键词] 超声;小儿;肠重复畸形;诊断价值

[中图分类号] R445.1;R725.7          [文献标识码] B          [文章编号] 1673-9701（2021）06-0116-03

The value of preliminary diagnosis of ultrasonography in children with intestinal duplication

YU Jiandong

Department of Ultrasound， Jiamusi Maternal and Child Health Care Hospital in Heilongjiang Province， Jiamusi   154002， China

[Abstract] Objective To analyze the value of preliminary diagnosis of ultrasonography in children with intestinal duplication. Methods The clinical data of 32 cases of children with intestinal duplication admitted to our hospital from February 2018 to March 2020 were retrospectively collected. Before operation， ultrasonography examination was performed in all of them. The postoperative pathological results were taken as the gold standard. The coincidence rate of preoperative ultrasound diagnosis was counted， and the features of ultrasound images were analyzed. Results Among 32 children with intestinal duplication confirmed by postoperative pathology， 28 cases were diagnosed as intestinal duplication by ultrasonography before operation， 2 cases were misdiagnosed， and 2 cases were missed. The diagnostic coincidence rate， misdiagnosis rate and missed diagnosis rate were 87.50%（28/32）， 6.25%（2/32） and 6.25%（2/32） respectively. In terms of lesions site， there were 20 cases（71.43%） in small intestine， 6 cases （21.43%） in colon and 2 cases （7.14%） in jejunum. In terms of pathological morphology， there were 20 cases（71.43%）（extraluminal type in 16 cases， endoluminal type in 4 cases） in cyst type， and 8 cases（28.57%） in tubular type. In terms of complications， there were 1 case complicated with intussusception， 2 cases complicated with intestinal obstruction， 3 cases complicated with infection， 1 case complicated with intestinal torsion and necrosis， 1 case complicated with intestinal perforation and 8 cases complicated with gastrointestinal hemorrhage. Conclusion Ultrasonography is a simple， noninvasive and economical method with high detection rate and accuracy， which can be used as the first choice for the preliminary diagnosis of children with intestinal duplication before surgery.

[Key words] Ultrasound; Children; Intestinal duplication; Diagnostic value

小儿肠重复畸形是胚胎期发生的一种消化道畸形，多发生于≤2岁的小儿，其主要是指附着于消化道系膜缘的、具有与消化道壁结构相似的球形或管形空腔肿物，多发生于小肠，约占75%，且以回盲部多见[1-2]。小儿肠重复畸形是引起消化道出血的危险因素之一，可引起腹痛、呕吐、便血、腹腔包块、肠梗阻等急腹症表现，一经确诊手术切除是唯一的有效治疗方案[3-4]。既往臨床上主要采取消化道造影、CT等进行术前诊断，具有操作较为复杂的特点[5-6]。当前随着超声诊断技术的发展，超声以其经济、简便、无创、无辐射等优势成为术前诊断该病的有效方法，本研究旨在探讨超声检查对小儿肠重复畸形的初步诊断价值，现报道如下。……