Objective: To investigate the value of abdominal ultrasound in diagnosing neonatal necrotizing enterocolitis (NEC) and its significance in evaluating the disease severity.
Methods: The clinical data of 84 neonates who were diagnosed with NEC between July 2013 and January 2015 were analyzed retrospectively. According to the modified Bell-NEC staging criteria, these neonates were divided into a suspected NEC group (n=44) and a confirmed NEC group (n=40); according to clinical prognosis, they were divided into a medical treatment and full recovery group (n=58) and a surgery/death group (n=26). The changes in the results of abdominal ultrasound and abdominal X-ray plain film were compared between groups.
Results: In the confirmed NEC group, abdominal ultrasound showed significantly higher detection rates of portal venous gas and dilatation of the intestine than abdominal X-ray plain film (P<0.05). Compared with the medical treatment and full recovery group, the surgery/death group had significantly higher detection rates of dilatation of intestine, bowel wall thickening, peritoneal effusion and free intraperitoneal air (P<0.05). Dilatation of the intestine and free intraperitoneal air shown by abdominal X-ray plain film were more common in the surgery/death group.
Conclusions: Abdominal ultrasound is useful for the diagnosis of NEC. Ultrasonic findings can contribute to the prediction of the severity of NEC.
目的: 探讨腹部超声检查对新生儿坏死性小肠结肠炎(NEC)的诊断价值及其在NEC病情评估中的意义。
方法: 回顾性分析2013年7月至2015年1月84例NEC患儿的临床资料。根据修正Bell-NEC分级诊断标准分为NEC疑似组(n=44)、确诊组(n=40);另根据临床转归分为内科治愈组(n=58)和手术/死亡组(n=26), 比较腹部超声及腹部X线平片检查结果在各组中的改变。
结果: 在确诊组, 腹部超声对门静脉积气、肠管扩张的检出率显著高于腹部平片(P < 0.05)。手术/死亡组腹部超声显示肠管扩张、肠壁增厚、腹腔积液及腹腔游离气体的检出率显著高于内科治愈组(P < 0.05);腹部平片仅显示肠管扩张及腹腔游离气体多见于手术/死亡组(P < 0.05)。
结论: 腹部超声在NEC的诊断中有重要作用; 超声表现对预测疾病的严重程度有预测作用。