黑龙江省绥化市第一医院超声科
小儿肠套叠是小儿外科常见急腹症之一,是一部分肠管及肠系膜套入邻近肠腔内的一种梗阻,在婴儿期尤为常见。一般为近侧肠管套入远侧肠管套叠处形成3层肠壁,最多肠套叠是回盲部。主要临床表现为腹痛、呕吐、血便、腹部包块。
目的:探讨小儿肠套叠的彩色多普勒超声影像学特点及诊断价值。
方法:对我院门诊及住院患儿采用PHILP—HD15彩超仪,首先用35MHz腹部常规探头行腹部扫查,避免漏诊,看腹腔内有元肿块,肿块位置肠腔有否梗阻扩张及有无腹腔积液,确定肿块后改用高频探头,对肿块多切面扫查,测量肿块大小,观察肿块边界、内部结构,肿块内有无血流信号。
结果:通过多次临床观察,右侧腹部为好发部位,其声像图表现为病变近端可见肠粘膜水肿的低回声肠壁增厚。横切面扫查表现为多层高低相间的“同心圆”征,纵切面扫查见多层肠壁平行排列,表现为上下对称高低相间的回声带呈“套筒征”。常合并肠梗阻的声像图表现,病变以上时有肠腔内淤滞。
结论:采用高频超声能明显提高声像图分辨力,可大提高确诊率。确诊后,可及时采取治疗措施。为小儿外科采用非手术方法水压复位争取时间。避免X线为患儿的辐射。因此,在高频超声监视下复位目前是最好的方法。
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Application of color Doppler ultrasound in the diagnosis of intussusception in children
Objective:Color Doppler ultrasound imaging of intussusception in children learn the characteristics and the diagnostic value.
Method:In our hospital out-patient and hospitalization in children with the use of PHILP - HD15 color Doppler ultrasound,first use the 35MHz routine abdominal probe for abdominal scan,to avoid misdiagnosis,see intraperitoneal element mass,tumor position has not intestinal lumen obstruction and no peritoneal effusion,determining tumor after the switch to high frequency probe of lumps,multi section scanning tumor size,measurement,observation of internal structure,in the tumor mass boundary,there is no blood flow signal.
Results:Many times through the clinical observation,the right side of the abdomen as the primary site,the ultrasonographic features of hypoechoic bowel wall thickening is visible proximal to the lesion of intestinal mucosa edema.Transnot showed multilayer level and "concentric circles" syndrome,sagittal scan see multilayer intestinal wall are arranged in parallel,the performance for the symmetrical alternating with low echo with a sleeve sign".Ultrasonographic features of often complicated with intestinal obstruction,intestinal cavity above the lesion when stasis.
结论:
Conclusion:Using high frequency ultrasound can significantly improve the sonographic resolution,can improve the diagnostic rate.After the diagnosis,timely take measures of treatment.For pediatric surgical operation method using non hydrostatic reduction for time.Avoid X-ray radiation for children.Therefore,reduction in the high frequency ultrasonic monitoring is currently the best method.
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论文作者:焦洪霞
论文发表刊物:《健康世界》2015年7期
论文发表时间:2015/10/30
标签:多普勒论文; 肠套叠论文; 超声论文; 小儿论文; 肿块论文; 彩色论文; 肠管论文; 《健康世界》2015年7期论文;