摘要
目的探讨经腹壁联合经会阴超声对先天性巨结肠儿童术后并发症的诊断价值。资料与方法回顾性分析行超声检查的114例先天性巨结肠术后患儿的超声声像图资料,以手术、病理结果和临床特征为诊断“金标准”,计算超声检查的敏感度、特异度、阳性预测值、阴性预测值,采用Kappa检验评价超声检查与诊断“金标准”的一致性。结果114例患儿中,23例(20.2%)出现手术相关并发症,包括巨结肠相关小肠结肠炎(HAEC)6例,吻合口漏2例,各种瘘道形成3例,吻合口裂开2例,脱出肠管扭转2例,吻合口狭窄2例,病变段残留4例,术后出血2例。超声发现19例并发症,漏诊2例HAEC、1例吻合口裂开和1例脱出肠管扭转。超声检查的敏感度、特异度、阳性预测值、阴性预测值分别为82.6%、100.0%、100.0%、95.8%。超声检查与诊断“金标准”的一致性较好(Kappa=0.883,P<0.001)。结论经腹壁联合经会阴超声检查对先天性巨结肠术后并发症的监测有一定的诊断价值。
Purpose To explore the value of transabdominal and transperineal ultrasound for the assessment of postoperative complications in children with Hirschsprung disease.Materials and Methods Sonographic images of 114 postoperative children of Hirschsprung disease were retrospectively analyzed.With surgery,biopsy and clinical information as the"gold standards",the sensitivity,specificity,positive predictive value and negative predictive value were calculated.Kappa test was used to evaluate the consistency of ultrasound examination and the"gold standards"of diagnosis.Results Postoperative complications were found in 23(20.2%)of the 114 children,including HAEC(n=6),anastomotic leakage(n=2),fistula(n=3),anastomotic dehiscence(n=2),twist pall-through(n=2),anastomotic stricture(n=2),residual aganglionosis(n=4),postoperative bleeding(n=2).Nineteen cases of complications were correctly identified by ultrasound;2 cases of HAEC,1 case of anastomotic dehiscence and 1 case of twist pall-through were missed diagnosis.The sensitivity,specificity,positive predictive value and negative predictive value of ultrasound were 82.6%,100.0%,100.0%and 95.8%,respectively.Ultrasound examination showed a good consistency with the"gold standards"(Kappa=0.883,P<0.001).Conclusion A combination of transabdominal and transperineal ultrasound has a certain value in detecting postoperative complications of Hirschsprung disease.
作者
马亚
李颀
张震
肖萍
闫淯淳
姜茜
MA Ya;LI Qi;ZHANG Zhen;XIAO Ping;YAN Yuchun;JIANG Qian(不详;Department of General Surgery,Capital Institute of Pediatrics,Beijing 100020,China)
出处
《中国医学影像学杂志》
CSCD
北大核心
2021年第1期60-64,共5页
Chinese Journal of Medical Imaging
基金
北京市属医院科研培育项目(PX2020054)。
