| 摘要: |
| 目的：探讨高频超声及术中腔内超声造影在小儿化脓性阑尾炎合并粪石形成内镜下逆行阑尾炎治疗术(ERAT,Endoscopic retrograde appendicitis therapy,ERAT)联合数字化胆道子镜(以下简称子镜)治疗中的应用价值。方法：回顾性分析我院2022年9月至2023年11月收治的化脓性阑尾炎合并粪石形成的48例患儿,所有患儿治疗前均用高频超声精准评估；治疗过程中结合术中超声造影观察并记录粪石是否成功取出、阑尾有无穿孔,根据内镜治疗结果分为取石成功组与术中穿孔组,分析超声与子镜在治疗过程中所见的符合率；治疗后两组患儿均定期复查超声并测量记录各相应指标,对比各观察指标恢复正常参考值时间、伴随症状消失时间及化验检查恢复正常时间。对两组患儿治愈优良率、并发症等进行分析。结果：本研究中,取石成功39例,术中穿孔9例。两组治疗后的超声观察阑尾壁及网膜厚度、发热、腹痛症状及WBC计数和CRP的恢复时间均有明显统计学差别；取石成功组未见明显并发症,术中穿孔组有1例患儿出现阑尾周围包裹性脓肿,但两组的治愈优良率分别为100.00％和88.89％,两组间比较无统计学差异(P＞0.05)。结论：高频超声及术中腔内超声造影引导ERAT联合数字化胆道子镜治疗小儿化脓性阑尾炎合并粪石实时精准,治愈优良率较高且并发症少,可作为该病有效的保守治疗方式,值得推广应用。 |
| 关键词: 小儿化脓性阑尾炎 粪石 高频超声 超声造影 内镜治疗 |
| DOI： |
| 投稿时间：2024-01-10修订日期：2024-06-11 |
| 基金项目: |
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| Analysis of the application value of ultrasound in the treatment of pediatric suppurative appendicitis with fecal stone formation using ERAT combined with digital cholangioscopy |
| guoxiaoya,yanghengli,lijinghua,yangyilin,zenglingchao,wangchunhui,yangruijing |
| () |
| Abstract: |
| Objective: To explore the application value of high frequency ultrasound and intraoperative contrast-enhanced ultrasound (CEUS) in the treatment of pediatric suppurative appendicitis with fecaliths by endoscopic retrograde appendicitis therapy (ERAT) combined with digital cholangioscopy. Methods: Retrospective analysis of 48 children with suppurative appendicitis and fecaliths formation admitted to our hospital from September 2022 to November 2023. All patients were accurately evaluated using high-frequency ultrasound before treatment. During the treatment process, combined with intraoperative contrast-enhanced ultrasound imaging, the successful fecaliths removal and the presence or absence of perforation in the appendix were observation and recorded. According to the endoscopic treatment results, the patients were divided into two groups: the successful fecaliths removal group and the intraoperative perforation group, the consistency between the ultrasound and endoscopic findings during the treatment process was analyzed. After treatment, both groups of children underwent regular ultrasound examinations and recorded corresponding indicators. The time for each observation indicator to return to normal reference values, the time for accompanying symptoms to disappear, and the time for laboratory tests to return to normal were compared. Analyze the excellent and good cure rates, complications, etc. of the two groups of children.Results: In this study,there were 39 successful fecaliths removal cases and 9 intraoperative perforation cases. There were significant statistical differences in ultrasound observation of the thickness of the appendix wall and omentum, fever, abdominal pain symptoms, WBC count, and recovery time of CRP between the two groups after treatment; There were no significant complications in the successful fecaliths removal group, and one patient in the intraoperative perforation group developed a periappendiceal encapsulated abscess. However, the cure and excellent rates of the two groups were 100.00% and 88.89%, respectively, with no statistical difference between the two groups (P>0.05).Conclusion: High frequency ultrasound and intraoperative contrast-enhanced ultrasound guided ERAT combined with the digital cholangioscopy for the treatment of pediatric suppurative appendicitis with fecaliths are real-time and accurate, with a high cure rate and fewer complications. They can be an effective conservative treatment method for this disease and are worth promoting and applying. |
| Key words: Pediatric suppurative appendicitis Fecaliths High frequency ultrasound Contrast-enhanced ultrasound Therapeutic endoscopy |
