超声在婴幼儿食管裂孔疝术前诊断中的临床价值

徐玉妹; 左维嵩; 胡锐; 刘浩; 陈俊

doi:10.13898/j.cnki.issn.1000-2200.2016.12.042

留言板

尊敬的读者、作者、审稿人, 关于本刊的投稿、审稿、编辑和出版的任何问题, 您可以本页添加留言。我们将尽快给您答复。谢谢您的支持!

姓名
邮箱
手机号码
标题
留言内容
验证码

超声在婴幼儿食管裂孔疝术前诊断中的临床价值

徐玉妹 , 左维嵩 , 胡锐 , 刘浩 , 陈俊

文章导航 > 蚌埠医学院学报 > 2016, 41 > 12: (1670-1672)

引用本文:

Citation:

超声在婴幼儿食管裂孔疝术前诊断中的临床价值

1. 南京医科大学附属南京医院(南京市第一人民医院) 功能检查科, 210000;
2. 南京医科大学附属儿童医院超声诊断科, 江苏南京 210000

作者简介: 徐玉妹(1986-),女,住院医师.

基金项目:
南京医科大学科技发展基金面上项目（2014NJMU161）
中图分类号: R655.4

The clinical value ofultrasonographyinthe preoperativediagnosis of esophageal hiatal hernia in infants

1. Department of Function Inspection, Nanjing First Hospital Nanjing Medical University, Nanjing Jiangsu 210000;
2. Department of Ultrasound, Nanjing Children's Hospital Affiliated to Nanjing University, Nanjing Jiangsu 210000, China
CLC number: R655.4

摘要: 目的：探讨婴幼儿食管裂孔疝的超声诊断特点及其与临床手术的相关性。方法：回顾性分析经超声诊断、消化道造影及手术证实的15例食管裂孔疝的超声图像特征，通过测量增大的食管裂孔内径与正常组45名进行统计学分析，探查膈上疝入物以及判断疝入物对于胸腔脏器的影响。结果：15例患儿首诊为食管裂孔疝均由超声实现，结合消化道造影及手术结果，诊断符合率100%。食管裂孔组的食管裂孔内径均有不同程度的增大，与正常组差异有统计学意义（P<0.05）；膈上疝入物多样，超声探查包括胃组织15例，贲门14例，食管下段14例，部分肝脏组织3例，肠管1例，可单独疝入亦可联合疝入胸腔；疝入物压迫心肺造成肺不张2例，心脏移位1例。结论：婴幼儿食管裂孔疝超声特征明显，通过测量增大的食管裂孔内径，探查膈上疝入物以及判断心肺压迫情况，有助于临床判断食管裂孔疝分型，及早手术，超声可成为无创性筛选婴幼儿食管裂孔疝的首选方法。
- 食管裂孔疝 /
- 超声检查 /
- 婴幼儿
Abstract: Objective: To investigate the ultrasound diagnostic features of esophageal hiatal hernia in infants,and its correlation with the clinical surgery.Methods: The ultrasound image features of esophageal hiatal hernia diagnosed by ultrasound,gastrointestinal imaging and operation in 15 infants were retrospectively analyzed.The enlarging inner diameter of the esophageal hiatus and 45 normal esophageal hiatus were statistically analyzed.The inside tissue of hernia above diaphragm was detected,and the effect of which on thoracic organ was investigated.Results: Fifteen infants with esophageal hiatal hernia were diagnosed by ultrasound,gastrointestinal imaging combined with operation,the diagnostic coincidence rate was 100%.The inner diameter of the esophageal hiatal hernia in esophageal hiatal group increased at various degree,the difference of which between two groups was statistically significant(P<0.05).The ultrasound detection showed that the inside tissue of hernia included 15 cases of stomach,14 cases of cardia,14 cases of lower esophagus,3 cases of the part liver and 1 case of bowel,and these tissue could enter alone or together.The atelectasis in 2 cases and cardiac displacement in 1 case were identified.Conclusions: The ultrasound characteristics of esophageal hiatal hernia is obvious in infant.Measuring the inside diameter of esophageal hiatus and probing the tissue above the diaphragm and cardiopulmonary oppression can contribute to judge the esophageal hiatal hernia type,and operate as possible as early in clinic.Ultrasound may become the preferred method of noninvasive screening the esophageal hiatal hernia in infants.
- esophageal hiatal hernia /
- ultrasonography /
- infant

[1]	邓陶然,李维娜,邓豫,等.食管裂孔疝的诊治[J].实用医学杂志,2014,30(19):3183.
[2]	ANDRICI J,TIO M,COX MR,et al.Hiatal hernia and the risk of Barrett's esophagus[J].J Gastroenterol Hepatol,2013,28(3):415.
[3]	ROBINSON PD,FITZGERALD DA.Congenital diaphragmatic hernia [J].Paediatr Respir Rev,2007,8(4):323.
[4]	Scheffer RC,Bredenoord AJ,HEBBARD GS,et al.Effect of proximal gastric volume on hiatal hernia[J].Neurogastroenterol Motil,2010,22(5):552.
[5]	SCARPATO E,D'ARMIENTO M,MARTINELLI M,et al.Impact of hiatal hernia on pediatric dyspeptic symptoms[J].J Pediatr Gastroenterol Nutr,2014,59(6):795.
[6]	李义红,李献亮,韩文峰,等.胃超声造影诊断食管裂孔疝的价值[J].中华医学超声杂志(电子版),2012,9(6):525.
[7]	MITIEK MO,ANDRADE RS.Giant hiatal hernia[J].Ann Thorac Surg,2010,89(6):S2168.
[8]	接连利,许燕,陈希平,等.产前超声诊断胎儿先天性膈疝的价值[J].中华超声影像学杂志,2008,17(3):234.
[9]	CAKMAKCI E,CELEBI I,TAHTABASI M,et al.Accuracy of ultrasonography in the diagnosis of sliding hiatal hernias[J].Acad Radiol,2013,20(4):453.
[10]	马丽霜,李龙,张悦,等.腹腔镜手术治疗婴幼儿食管裂孔疝的探讨[J].中华小儿外科杂志,2010,31(10):728.
[11]	沈立,钱龙宝,莫绪明,等.小儿先天性食管裂孔疝的外科治疗方法探讨[J].医学研究生学报,2010,23(2):175.
[12]	LEUNG AW,LAM HS,CHU WC,et al.Congenital intrathoracic stomach:short esophagus or hiatal hernia [J].Neonatology,2008,93(3):178.

[1]	刘训芹 , 鲁显福 , 顾尔伟 , 张雷 , 曹袁媛 . 超声成像测定婴幼儿先天性心脏病患者颈内静脉横截面积及实时引导中心静脉置管术的临床意义. 蚌埠医学院学报, 2015, 40(8): 1087-1090. doi: 10.13898/j.cnki.issn.1000-2200.2015.08.034
[2]	汪建超 , 许建明 . 食管裂孔疝的内镜诊断价值. 蚌埠医学院学报, 2008, 33(5): 529-531.
[3]	冯慧敏 , 岳亿玲 , 宋仲福 , 黄明华 , 何金凤 , 杨娟 . 皖北矿区婴幼儿气质特点调查分析. 蚌埠医学院学报, 2009, 34(4): 345-347.
[4]	凌久德 , 王东涛 , 蒋鹏 , 王远恩 , 褚植伦 . 婴幼儿腭裂修复118例临床分析. 蚌埠医学院学报, 2011, 36(10): 1092-1094.
[5]	蒋俊豪 . 婴幼儿复发鹅口疮血常规分析. 蚌埠医学院学报, 2012, 36(9): 1086-1087.
[6]	谢同炳 , 袁加明 , 李晓东 . 婴幼儿轮状病毒性肠炎合并良性惊厥14例临床分析. 蚌埠医学院学报, 2008, 33(2): 201-202.
[7]	王彦波 , 杨海燕 , 汤璘珊 . 大环内酯类药物在治疗婴幼儿喘息性疾病中的应用. 蚌埠医学院学报, 2013, 37(6): 713-715.
[8]	孙礼宾 , 王亚宁 . 三联雾化吸入治疗婴幼儿毛细支气管炎疗效观察. 蚌埠医学院学报, 2008, 33(1): 81-82.
[9]	徐向英 . 产前胎儿侧脑室扩张与婴幼儿神经系统发育的相关性. 蚌埠医学院学报, 2017, 42(6): 808-810. doi: 10.13898/j.cnki.issn.1000-2200.2017.06.035
[10]	王静 , 李晓红 . 丙泊酚中长链脂肪乳在婴幼儿麻醉中的应用效果观察. 蚌埠医学院学报, 2018, 43(3): 292-295. doi: 10.13898/j.cnki.issn.1000-2200.2018.03.004
[11]	林宏华 . 丙种球蛋白治疗婴幼儿重症肺炎的疗效观察. 蚌埠医学院学报, 2007, 32(5): 593-594.
[12]	张峰 , 丁力 , 胡英超 , 金丹群 . 10 kg以下婴幼儿室间隔缺损的手术治疗. 蚌埠医学院学报, 2008, 33(4): 435-436.
[13]	许东宝 , 陈寿伟 . 轻度胃肠炎伴发良性婴幼儿惊厥14例临床分析. 蚌埠医学院学报, 2004, 29(1): 54-55.
[14]	张莉 , 张成书 , 王君 , 林晓曦 , 王琛 , 王炜 . 大剂量皮质激素治疗婴幼儿血管瘤. 蚌埠医学院学报, 2007, 32(5): 525-527.
[15]	万凤国 , 何敏 , 丁云芳 . 婴幼儿腹泻轮状病毒感染情况分析. 蚌埠医学院学报, 2004, 29(5): 419-420.
[16]	吴红云 . 一次性头皮针管在婴幼儿保留灌肠中的应用. 蚌埠医学院学报, 2008, 33(1): 32-32.
[17]	吴士强 . 婴幼儿法洛四联征根治术77例治疗分析. 蚌埠医学院学报, 2014, 39(10): 1373-1375.
[18]	邸春阳 , 郭益新 , 徐玉新 , 季松茂 , 瞿丽平 , 聂青松 . 小剂量肝素联合维生素K₁佐治婴幼儿重症支气管肺炎疗效观察. 蚌埠医学院学报, 2008, 33(1): 68-70.
[19]	宣爱丽 , 孙谦 , 沈怀云 , 关艳春 , 陈云 , 郑迎娟 , 徐家丽 , 赵武 . 婴幼儿毛细支气管炎后反复喘息现状及影响因素分析. 蚌埠医学院学报, 2020, 45(9): 1232-1235, 1239. doi: 10.13898/j.cnki.issn.1000-2200.2020.09.024
[20]	李姝 , 刘浩 , 李光荣 , 杨明 , 朱善良 , 莫绪明 . 婴幼儿危重型先天性心脏病256层CT低管电压心脏增强扫描中造影剂最小剂量分析. 蚌埠医学院学报, 2021, 46(11): 1600-1603. doi: 10.13898/j.cnki.issn.1000-2200.2021.11.026

点击查看大图

计量

文章访问数: 4025
HTML全文浏览量: 488
PDF下载量: 76
被引次数: 0

超声在婴幼儿食管裂孔疝术前诊断中的临床价值

作者简介: 徐玉妹(1986-),女,住院医师.

1. 南京医科大学附属南京医院(南京市第一人民医院) 功能检查科, 210000;
2. 南京医科大学附属儿童医院超声诊断科, 江苏南京 210000

收稿日期: 2015-11-12

基金项目: 南京医科大学科技发展基金面上项目（2014NJMU161）

关键词:

摘要: 目的：探讨婴幼儿食管裂孔疝的超声诊断特点及其与临床手术的相关性。方法：回顾性分析经超声诊断、消化道造影及手术证实的15例食管裂孔疝的超声图像特征，通过测量增大的食管裂孔内径与正常组45名进行统计学分析，探查膈上疝入物以及判断疝入物对于胸腔脏器的影响。结果：15例患儿首诊为食管裂孔疝均由超声实现，结合消化道造影及手术结果，诊断符合率100%。食管裂孔组的食管裂孔内径均有不同程度的增大，与正常组差异有统计学意义（P<0.05）；膈上疝入物多样，超声探查包括胃组织15例，贲门14例，食管下段14例，部分肝脏组织3例，肠管1例，可单独疝入亦可联合疝入胸腔；疝入物压迫心肺造成肺不张2例，心脏移位1例。结论：婴幼儿食管裂孔疝超声特征明显，通过测量增大的食管裂孔内径，探查膈上疝入物以及判断心肺压迫情况，有助于临床判断食管裂孔疝分型，及早手术，超声可成为无创性筛选婴幼儿食管裂孔疝的首选方法。

English Abstract

The clinical value ofultrasonographyinthe preoperativediagnosis of esophageal hiatal hernia in infants

1. Department of Function Inspection, Nanjing First Hospital Nanjing Medical University, Nanjing Jiangsu 210000;
2. Department of Ultrasound, Nanjing Children's Hospital Affiliated to Nanjing University, Nanjing Jiangsu 210000, China

Received Date: 2015-11-12

Abstract: Objective: To investigate the ultrasound diagnostic features of esophageal hiatal hernia in infants,and its correlation with the clinical surgery.Methods: The ultrasound image features of esophageal hiatal hernia diagnosed by ultrasound,gastrointestinal imaging and operation in 15 infants were retrospectively analyzed.The enlarging inner diameter of the esophageal hiatus and 45 normal esophageal hiatus were statistically analyzed.The inside tissue of hernia above diaphragm was detected,and the effect of which on thoracic organ was investigated.Results: Fifteen infants with esophageal hiatal hernia were diagnosed by ultrasound,gastrointestinal imaging combined with operation,the diagnostic coincidence rate was 100%.The inner diameter of the esophageal hiatal hernia in esophageal hiatal group increased at various degree,the difference of which between two groups was statistically significant(P<0.05).The ultrasound detection showed that the inside tissue of hernia included 15 cases of stomach,14 cases of cardia,14 cases of lower esophagus,3 cases of the part liver and 1 case of bowel,and these tissue could enter alone or together.The atelectasis in 2 cases and cardiac displacement in 1 case were identified.Conclusions: The ultrasound characteristics of esophageal hiatal hernia is obvious in infant.Measuring the inside diameter of esophageal hiatus and probing the tissue above the diaphragm and cardiopulmonary oppression can contribute to judge the esophageal hiatal hernia type,and operate as possible as early in clinic.Ultrasound may become the preferred method of noninvasive screening the esophageal hiatal hernia in infants.