摘要
目的探讨无钙化斑的胎粪性腹膜炎的X线特征和鉴别诊断要点。方法回顾性分析54例胎粪性腹膜炎,其中45例手术治疗,按X线平片是否有腹部钙化斑,分为有钙化组(A)和无钙化组(B),对组内病例的临床资料、腹部X线平片特点、手术病理结果进行分析,并探讨其术后预后情况结果54例患者中腹部X线平片表现为肠梗阻27例,肠梗阻伴腹水23例,气腹12例。B组肠梗阻伴腹水、游离气腹的发生率较A组高,合并肠坏死、肠穿孔、肠扭转的比例较高;产前B超异常的比例B组(62.5%)明显高于A组(36.8%);A、B组各有4例术后出现需手术治疗的粘连性肠梗阻。结论胎粪性腹膜炎X线平片表现以肠梗阻多见。无钙化斑者发生肠坏死、肠穿孔、肠扭转的可能大,预后差。无钙化斑的胎粪性腹膜炎X线诊断要点为肠梗阻伴腹水,结合产前B超,可做出正确诊断,应及时手术。
Objective To discuss the characteristics of X-ray plain film in infants with meconium peritonitis without calcification, and to evaluate the significance of these characteristics in the etiological diagnosis, treatment and prognosis. Methods Fifty four infants with meconium peritonitis were retrospectively analyzed, including clinical history, X-ray plain films and pathological results. We divided patients into group A with calcification on X-ray plain fihn and group B without calcification on X-ray plain film. The relation between X-ray findings and pathological diagnosis and prognosis were also evaluated. Results Through the retrospective analysis of 54 cases with meconium peritonitis, we found that intestinal obstruction often demonstrated in X-ray plain film of the infants of our series. The ratio of group A and B was 38：16. Fourteen patients in group A presented various anomalies in prenatal ultrasonography, including10 cases in group B. The ratio of finding intestinal obstruction mergering of ascites and flee pneumoperitoneum m X-ray plain film was higher in group B than in group A. Forty five cases in our series were operated, of which 34 cases for emergency surgery. In group B , all these 16 cases operated emergency surgery and the surgery confirmed that the merging necrosis, intestinal perforation and volvulus were of the higher proportion in group B than in group A. There were 4 cases presenting adhesive intestinal obstruction after surgery both in group A and B, Conclusion Intestinal obstruction often demonstrates in X-ray plain film in infants with meconium peritonitis. The most common complication is intestinal atresia. The cases without calcification are in high risk of intestinal necrosis, intestinal perforation and volvulus. It shall be taken seriously that the prognosis of the cases without calcification is poorer than those with calcification. The X-ray plain fihn combined with prenatal ultrasonography is the important for the early diagnosis of MP without calcification, and they shall be further dealt with timely surgery.
出处
《上海医学影像》
2010年第1期18-21,共4页
Shanghai Medical Imaging
关键词
胎粪性腹膜炎
钙化
X线平片
诊断
治疗
Meconium peritonitis
Calcification
X-ray plain film
Diagnosis
Treatment
