超声检查在小儿肠息肉继发性肠套叠诊断中的作用

摘要

目的 探讨超声检查在小儿肠息肉继发性肠套叠中的诊断价值,并总结其声像图的特点,为临床治疗方式的选择提供依据.方法 回顾性分析我院因肠息肉致肠套叠的36例患儿的超声图像、治疗方法及效果.结果 36例患儿均具有肠套叠的典型超声表现,即短轴呈"同心圆"征,长轴呈"假肾"征,超声诊断结果与临床诊断一致.其中10例(27.8%)超声诊断出息肉病变,声像图表现为在套头内或套头边缘发现实质性病变,为中等回声;CDFI可见丰富的放射状血流信号,明确诊断后,临床采用空气灌肠后行电子肠镜息肉切除术,顺利恢复出院.仍有26例患儿超声仅发现肠套叠征象,行空气灌肠后又复发肠套叠,23例(63.9%)患儿行剖腹探查及肠息肉切除术,3例(8.3%)患儿行剖腹探查及肠切除肠吻合术.结论 超声可准确判断套叠部位肠壁的血供,并发现息肉帮助临床明确病因,从而指导治疗方式的选择.%Objective To assess the diagnostic value of children's secondary intussusception caused by colonic polyp using ultraonography.Methods Data including image and therapy of 36 children with intussusception due to colon polyp were enrolled and retrospectively analyzed.Results Thirty-six cases showed the typical sonographic features of intussusception, including "concentric circle" sign in the short axis,and the "false kidney" sign in the long axis,and the ultrasonic diagnosis was consistent with the clinical diagnosis.The polyps with medium echo was detected in 10 cases(27.8%),which was in the cuff or at the edge of the cuff of the colon sleeve,with aboudant blood flow.The electronic colonoscopy polypectomy was performed on children with confirmed diagnosis.For another 26 children,only signs of intussusception were found by ultrasonography,air enema was performed on these children,but all were recurred.For these 26 cases,laparotomy and intestinal resection were performed on 3 of them,laparotomy and intestinal polyps resection were performed on another 23 cases.Conclusion Ultrasound can identify the intussusception caused by intestinal polyps,which can help to choose the treatment method.