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目的:探究腹部超声检查对新生儿坏死性小肠结肠炎(NEC)的临床应用价值。方法:选取2009年1月-2016年12月我院收治116例患有NEC的新生儿作为本次研究的对象,依据修正Bell-NEC分级标准将之分为确诊组(n=50)和疑似组(n=66),再依据临床转归分为手术组(n=37)和内科治愈组(n=79),对比确诊组和疑似组的腹部超声与X线检查结果,以及内科治愈组和手术组的腹部超声与X线检查结果。结果:在确诊组和疑似组中,腹部超声对肠壁积气、门静脉积气的检出率均高于X线摄片(P<0.05)。腹部超声还发现了肠道蠕动缓慢、肠道蠕动消失和腹腔积液;内科治愈组腹部超声对肠壁增厚、肠管扩张和腹腔积液的检出率低于手术组(P<0.05);内科治愈组X线摄片对肠管扩张的检出率低于手术组(P<0.05)。结论:腹部超声能够提高NEC的检出率,且对NEC的临床转归有较好的预测作用。
Objective: To investigate the clinical value of abdominal ultrasonography in the diagnosis of neonatal necrotizing enterocolitis (NEC). Methods: From January 2009 to December 2016, 116 newborns with NEC in our hospital were enrolled in this study. According to the modified Bell-NEC grading standards, they were divided into the diagnosis group (n = 50) and the suspected (N = 66), and then divided into surgery group (n = 37) and medical cure group (n = 79) according to the clinical outcome. The results of abdominal ultrasound and X-ray examination of the diagnosed group and the suspected group were compared with those of the cured group Abdominal ultrasonography and X-ray findings of the surgery group. Results: In the diagnosed group and the suspected group, the detection rates of abdominal gas and portal venous gas were higher than that of X-ray (P <0.05). Abdominal ultrasonography also found slow intestinal motility, disappearance of intestinal peristalsis and peritoneal effusion. The rate of abdominal wall thickening, bowel dilatation and peritoneal effusion in the cured group was lower than that in the surgical group (P <0.05). The rate of bowel dilatation detected by X-ray in medical cure group was lower than that in operation group (P <0.05). Conclusion: Abdominal ultrasonography can improve the detection rate of NEC and has a good predictive value for the clinical outcome of NEC.