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目的探讨消化道造影与多普勒超声在不同年龄儿童先天性肠旋转不良诊断中的意义。方法回顾性分析2012年3月-2015年2月医院收治的100例先天性肠旋转不良患儿临床资料及术前消化道造影与超声检查结果,将两种检查结果进行对比分析。结果两组患儿主要症状均为胆汁性呕吐、便秘、腹胀,新生儿与非新生儿组腹痛发生率有显著性差异(P<0.05);与手术结果对照,患儿术前消化道造影检查确诊86例(占86.0%)肠旋转不良,其中新生儿组共检出52例,非新生儿组共检出34例,多普勒超声检查确诊74例(占74.0%)肠旋转不良,新生儿组共检出48例,非新生儿组共检出26例;患儿术前消化道造影检查与超声检查确诊率比较,差异具有统计学意义(χ~2=4.500,P=0.03);消化道造影在肠旋转不良无肠扭转确诊率新生儿组(52.9%)与非新生儿组(90.9%)比较,差异具有统计学意义(χ~2=4.4140,P=0.036);消化道造影与多普勒超声在新生儿肠旋转不良合并肠扭转确诊率(97.6%,73.2%)比较,有显著性差异(χ~2=9.9071,P=0.004)。结论不同年龄儿童先天性肠旋转不良诊断可采用消化道造影及多普勒超声检查,消化道造影对新生儿肠旋转不良合并肠扭转的诊断率较高。
Objective To investigate the significance of gastrointestinal imaging and Doppler ultrasound in the diagnosis of congenital intestinal malrotation in children of different ages. Methods The clinical data of 100 cases of congenital dysplasia of the intestine and the results of preoperative digestive tract imaging and ultrasonography were retrospectively analyzed from March 2012 to February 2015 in our hospital. The results of two tests were compared and analyzed. Results The main symptoms of both groups were bile vomiting, constipation, abdominal distension, the incidence of abdominal pain in neonates and non-neonates was significantly different (P <0.05). Compared with the surgical results, preoperative gastrointestinal imaging Totally 86 cases (86.0%) were diagnosed as malrotated bowel, of which 52 cases were detected in the neonatal group, 34 cases were detected in the non-neonatal group, 74 cases (74.0%) were diagnosed by Doppler ultrasonography, A total of 48 cases were detected in the pediatric group and 26 cases in the non - neonatal group. The difference between the preoperative gastrointestinal imaging and the ultrasonography was statistically significant (χ ~ 2 = 4.500, P = 0.03). Gastrointestinal angiography showed no significant difference in diagnosing rate of bowel malrotation without bowel and intestine (52.9%) and non-neonatal group (90.9%) (χ ~ 2 = 4.4140, P = 0.036) Compared with Doppler ultrasound, the diagnosis rate of bowel malformation (97.6%, 73.2%) was significantly different between two groups (χ ~ 2 = 9.9071, P = 0.004). Conclusions The diagnosis of congenital intestinal malrotation in children of different ages can be diagnosed by digestive tract imaging and Doppler ultrasonography. The diagnostic rate of gastrointestinal angiography is very high in neonates with malrotation of intestine.