摘要
目的探讨新生儿坏死性小肠结肠炎X线表现，加深对本病的进一步认识。方法收集我院1998—2005年经X线及临床确诊病例32例。均采用腹部仰卧前后位、立住摄片，必要时摄水平倒位片及多体位腹透方法诊断，对早期病变采用间隔12-24h追踪观察，观察其病变发展过程，指导临床及早采取相应的治疗措施。结果32例中，30例为早产儿，2例为未足周产儿，诊断早期表现仅5例，主要X线表现为不完全性小肠梗阻，肠间隙增宽、模糊，腹脂线不清，占16％。典型期表现21例，主要X线表现为胃／肠壁内局限性壁内积气，肠管积气扩张，排列紊乱，部分肠管固定，占66％。晚期表现6例，主要X线表现为胃肠壁内广泛散在积气及气腹影，占18％。32例病例中，伴门静脉积气2例，伴胃肠穿孔4例，除2例死亡外，其余30例经临床治疗病愈后出院。结论新生儿坏死性小肠结肠炎早期X绒表现不明显，容易误诊、漏诊，若临床怀疑有NEC表现，X线检查一定要全面细致，如侧卧水平位投照可观察到少量气腹影，及早诊断胃肠穿孔，指导临床及早采取手术治疗，对挽救患儿生命具有重要价值。
Objective To discuss the X - ray appearance of necrotic enterocolitis （NEC） of neonate and improve the further recognition. Methods 32 cases of such patient who obtained the diagnosis with X - ray and clinic from 1998 to 2005 were analyzed, The A - P X - ray in supination and erect position was taken and lateral projection or inspectscope with X - ray were taken if necessary. The early lesion was taken monitor every 12 or 24 hours to observe the changes and indicate the relative treatment. Results There were 5 cases of 32 in early stage, 21 cases in typical and 6 cases in late stage when diagnosed. The early appearance was un - complete obstructive of small intestine, widen and obscure of its interspace, unclear of abdominal fat line. The typical appearance was local pneumatosis of intra - gastrointestinal wall and track dilated with disorder as some of them fixed. The late appearance was the extensive pneumatosis of intra - gastrointestinal wall and image of aeroperitoneum, There were male 22 and female l0 cases with average age of 4 days （ 12 h - 8 day）. There were 2 cases of pneumatosis of portal vein, 4 cases of perforation of digestive tract and 2 died. The other were cured. Conclusion The appearance of early stage might be unclear that easily lead to misdiagnosed. The detail and monitor of X - ray detection should be taken when the case is doubted NEC so that to indicate the further treatment procedure such as operation when needed to improve survival rate.
出处
《黑龙江医学》
2006年第1期3-5,共3页
Heilongjiang Medical Journal
