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高频超声在幼儿腹股沟疝的影像特征分析
范晓娟,张宝娟,刘广禄
0
(宝鸡市妇幼保健院功能科)
摘要:
【摘要】目的 探索提高幼儿腹股沟疝B超诊断准确率的有效方法,以期为临床治疗提供可靠技术支持。方法 患儿平卧位及站立位时,用高频超声探查腹股沟疝情况,确定发病部位,观察疝囊外形、走向、与腹腔相通处、与阴囊的关系及疝囊颈与腹壁下动脉的关系等,统计分析B超诊断结果。结果 148例外科查体准确率为73.65%,经B超诊断为腹股沟疝的患儿,经手术确认3例漏诊或误诊,其准确率为97%。5例临床拟诊为单侧疝,经B超、手术均确认为双侧;148例腹股沟疝B超分型中仅有1例直疝被误诊为股疝,分型准确率为9932%;125例斜疝中,99例可探及梨形或长条性包块,其中61例(61.62%)疝内容物为肠管,38例(38.38%)疝内容物为大网膜;15例直疝内容物均为肠管;8例股疝内容物均为大网膜;15例直疝患儿在平卧位做乏氏动作时,均可探及内容物为肠管的球形包块;8例股疝患儿平卧位乏氏动作时,可探及从股静脉后内侧进入液性包块内大网膜高回声;20.80%的斜疝患儿,在平卧、安静呼吸时疝内容物完全在腹腔内,只有在患儿做乏氏动作时才可通过内环口进入腹股沟管,并被B超探及;B超检查的敏感度、特异度及准确率均明显优于外科查体检查(P<0.05)。结论 高频超声不仅对腹股沟疝可作出较为准确的诊断,同时可明确腹股沟疝的类型,对疝内容物作出鉴别,可作为腹股沟疝首选影像学检查手段。乏氏动作有助于不典型腹股沟疝的诊断。
关键词:  幼儿  腹股沟疝  B超声检查
DOI:
基金项目:陕西省自然科学基金(2011JM4019)
Study on ultrasound image characteristics and detection methods of children’s inguinal hernia
FAN Xiaojuan,ZHANG Baojuan,LIU Guanglu
(Department of Function, Shanxi Baoji Maternal and Child Health Hospital)
Abstract:
【Abstract】Objective To explore an effective method ,improve the accuracy of diagnosis of inguinal hernia in children in order and provide reliable technical support for clinical treatment. Methods In supine position and standing position, High frequency ultrasound was used to probe inguinal hernia, determine the site, observe the shape, trend, the relationship with the scrotum and the relationship between the scrotum and the abdominal wall. Results 148 patients of inguinal hernia diagnosed by B ultrasound were confirmed by operation. The diagnostic rate was 100 %. 5 cases were unilateral hernia, which were confirmed by B ultrasound and operation. In 148 cases of inguinal hernia, only 1 case was misdiagnosed as femoral hernia. The accuracy rate of classification was 99.32%. Of 125 cases of indirect hernia, 99 cases could be detected pear shaped or long strip mass. 61 cases (61.62 % ) hernia contents were bowel and 38 cases (38.38 % ) hernia were clathria membrane. The intestinal contents of 15 cases were bowel. The contents of 8 cases were clathria. 15 children with direct hernia could get the spherical mass of the intestinal canal in the supine position in the supine position. 8 patients with femoral hernia in the supine position could enter the greater omental sac from the inner side of the femoral vein. In children with 2080 hernia, the contents of hernia in prostration and quiet breathing were in the abdominal cavity completely. The inner collar extension could enter the inguinal canal through the valsalva action. The sensitivity, specificity and accuracy of Bultrasound examination were significantly better than that of the surgical examination (P<0.05). Conclusion High frequency ultrasound not only can make more accurate diagnosis of inguinal hernia, but also clear the type of inguinal hernia, and distinguish the content of inguinal hernia, which can be used as the first choice of imaging examination of inguinal hernia. Valsalva action can help the diagnosis of atypical inguinal hernia.
Key words:  Infants  Inguinal hernia  B ultrasound examination

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