摘要
目的探讨腹腔镜结合核素显像在小儿消化道出血，特别是Meckel憩室、肠重复畸形诊断和治疗中的应用。方法对我院1998年12月-2005年12月收治22例反复便血或黑便患儿进行”“锝酸盐（^99mTcO4^-）显像检查，均行腹腔镜探查术。结果22例中18例^99mTcO4^-显像阳性，4例^99mTcO4^-显像阴性^99mTcO4^-显像阳性的患儿均经腹腔镜探查及病理证实，其中14例Meckel憩室，4例小肠重复畸形；4例”^99mTcO4^-显像阴性患儿行腹腔镜探查术，3例未见器质性病变，1例经手术及病理证实为Meckel憩室。结论核素显像是诊断小儿消化道出血的重要手段，可为手术治疗提供诊断依据。腹腔镜结合核素显像对小儿消化道出血不仅具有诊断及治疗价值，而且减少开腹探查的盲目性及创伤性。
Objective To explore the clinical value of laparoscopy combined with radionuclide imaging in the diagnosis and treatment of pediatric gastrointestinal hemorrhage, especially for Meckel＇ s diverticulum and double intestine. Methods^99mTcO4^-pertechnetate abdominal scintigraphy was performed in 22 children with a history of recurrent hemafecia or melena in this hospital from December 1998 to December 2005. All the children were given a laparoscopic exploration. Results Among the 22 patients, scintigraphy showed positive findings in 18 patients and negative, 4 patients. The positive patients were all confirmatively diagnosed by laparoscopic surgery and pathological examinations, including Meckel＇ s diverticulum in 14 patients and duplications of alimentary tract in 4 patients. In the other 4 patients with negative results, no organic pathologic changes was identified by laparoscopy in 3 patients and Meckel＇ s diverticulum was found after laparoscopic exploration in 1 patient. Conclusions Radionuclide imaging is an important method in the diagnosis of gastrointestinal tract hemorrhage in children and provides scientific basis for surgical intervention. The combination of laparoscopy and radionuclide imaging not only has values in the diagnosis and treatment of pediatric gastrointestinal hemorrhage, but also minimizes the blindness and trauma of exploratory laparotomy.
出处
《中国微创外科杂志》
CSCD
2006年第12期960-961,共2页
Chinese Journal of Minimally Invasive Surgery
关键词
消化道出血
放射性核素显像
儿童
腹腔镜
Gastrointestinal tract hemorrhage
Radionuclide imaging
Child
Laparoscopy
