小儿肠套叠超声表现与水压灌肠复位成败的相关性

    Correlation between the ultrasonographic performance of intussusception and success or failure of hydraulic enema reduction in children

    • 摘要:
      目的探讨影响水压灌肠复位成败的影响因素及其预测价值。
      方法回顾性分析小儿肠套叠126例临床资料,按照复位是否成功,分为复位成功组100例和复位失败组26例,比较2组基本资料和超声表现,采用logistic回归分析水压灌肠复位的影响因素,采用ROC曲线分析不同指标对复位成败的预测价值。
      结果复位成功组与失败组在有无血便、盆腔积液和肠套叠位置、血流分布、发病时间、同心圆宽径、同心圆厚径、套鞘厚径、套入长度方面差异均有统计学意义(P < 0.05~P < 0.01);logistic回归分析显示,同心圆宽径、血便、发病时间及套筒长度均为水压灌肠复位的独立影响因素(P < 0.01);以上指标联合预测复位成功的特异度为89.3%,敏感度为88.8%,AUC为0.933,特异度及敏感度均高于单独预测(P < 0.05)。
      结论超声多指标联合临床资料可对水压灌肠复位结果进行有效预测,有助于减轻患儿痛苦及降低无效治疗风险。

       

      Abstract:
      ObjectiveTo discuss the factors influencing the success or failure of hydraulic enema reduction and its predictive value.
      MethodsThe clinical data of 126 children with intussusceptions were retrospectively analyzed.The cases were divided into the success group(100 cases)and failure group(26 cases)according to whether the reduction was successful or not.The basic data and ultrasonic performance between two groups were compared.The logistic regression analysis was used to analyze the influencing factors of the reduction of hydraulic enema, and the ROC curve was used to analyze the predictive value of different indicators for the success or failure of reduction.
      ResultsThe differences of blood stool, pelvic effusion, intusculation location, blood flow distribution, onset time, concentric circle wide diameter, concentric circle thick diameter, sheath thick diameter and sleeve length were statistically significant(P < 0.05 to P < 0.01).The results of logistic regression analysis showed the width diameter of concentric circles, bloody stool, duration of intussusception and length of intussusception were the independent risk factors of reduction(P < 0.01).The specificity, sensitivity and AUC of combined prediction of the above factors were 89.3%, 88.8% and 0.933, respectively, and the specificity and sensitivity were higher than those of separate prediction(P < 0.05).
      ConclusionsThe ultrasound finding combined with clinical data can effectively predict the outcome of hydraulic enema reduction, and reduce the pain of children and risk of ineffective treatment.

       

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