彩色多普勒超声在小儿肠套叠选择复位方式中的价值

目的：探讨小儿肠套叠磁入部血管血流动力学变化，以选择其复位方式。方法：76名肠套叠患儿均行彩色多普勒血流显像，观察套叠肠管及肠系膜动静脉的血流动力学变化，然后进行空气灌肠复位，结果：空气灌肠复位成功61例，失败15例，后者行手术复位治疗，两组的动脉阻力指数差异有显著性意义。失败组的静脉流速和动脉峰速较复位成功组偏高，其中失败组1例患儿升结肠套入部无血流显示，结论：根据彩色多普勒超声对小儿肠套叠的血流动力学检测，可以正确选择复位方式，肠壁严重水肿，阻力指数显著升高，无血流显示等情况禁忌空气灌肠，应尽快手术复位。

The instructive value of color Doppler ultrasonography in air enema reduction of the child intussusception

Objective To investigate the feasibility of choosing the way of reduction according to the hemodynamics of the intussusceptive places examined by color Doppler flowing imaging(CDFI).Methods Seventy-six cases of intussusception had the examination of CDFI. The hemodynamic changes of the invaginative intestine and the mesenteric arteries and veins were observed and air enema reduction was done in all patients.Results Air enema reduction was perfomed successfully on 61 cases, and 15 failure cases underwent operative reduction. The resistance index (RI) was significantly different between two groups. The velocity of vein flow and the mean velocity of arterial peak in the failure group were higher than those in the success group. One case of the failure group had no flow imaging in invaginative part of ascending colon.Conclusions Color Doppler ultrasonography is a simple and useful method in monitoring the hemodynamic changes of the children intussusception and correctly chooseing the way of reduction.Operative reduction should be performed quickly when heavily swelling intestinal wall, significantly high RI, especially no flow imaging are demonstrated in color Doppler ultrasonography.