Comparison of diagnostic value of bedside high-frequency ultrasound and plain X-ray film in neonatal necrotizing enterocolitis
Objective To explore the diagnostic value of bedside high-frequency ultrasound and plain X-ray film in neonatal necrotizing enterocolitis (NEC). Methods The clinical data of 85 neonates with necrotizing enterocolitis were retrospectively analyzed. All patients underwent bedside high-frequency ultrasound and plain X-ray examination. Comparison of the positive detection rate of bedside high-frequency ultrasound and plain X-ray film for neonatal necrotizing enterocolitis at different stages,the detection rate of clinical characteristics of neonatal necrotizing enterocolitis at different stages,and the detection rate of different indications of neonatal necrotizing enterocolitis at early stage and late stage using clinical findings as the gold standard. Results Gold standard:of the 85 children,40 cases were in stage Ⅰ,23 cases in stage Ⅱ,and 22 cases in stage Ⅲ. There was no significant difference in the positive rate of stage Ⅰ and stage Ⅱ necrotizing enterocolitis between bedside high-frequency ultrasound and plain X-ray film (P>0.05). The positive rate of bedside high-frequency ultrasound for stage Ⅲ necrotizing enterocolitis was 90.91％,which was significantly higher than 45.45％ of plain X-ray film (P<0.05). In stage Ⅰ neonates,the detection rates of bedside high-frequency ultrasound for partial intestinal insufflation and dilatation,uneven distribution of intestinal insufflation,and thickening of intestinal wall edema were 100.00％,82.50％ and 85.00％,which were higher than 87.50％,15.00％ and 55.00％ of plain X-ray film (P<0.05). In stage Ⅱ neonates,there was no significant difference in the detection rate of pneumatosis intestinalis and portal venous gas between bedside high-frequency ultrasound and plain X-ray film (P>0.05). The detection rate of ascites by bedside high-frequency ultrasound was 69.57％,which was higher than 4.35％ by X-ray flat film (P<0.05). In stage Ⅲ neonates:there was no significant difference in the detection rate of fixed or persistent dilatation of intestinal loops and pneumomediastinum between bedside high-frequency ultrasound and X-ray flat film (P>0.05). The detection rate of localized perforation and turbid ascites by bedside high-frequency ultrasound was 31.82％,which was higher than 0 by plain X-ray flat film (P<0.05). The detection rates of bedside high-frequency ultrasound for intestinal wall thickening/intestinal space widening,abdominal effusion,intestinal adhesion and intestinal stenosis in early-stage neonates were 100.00％,6.45％,9.52％ and 7.94％,which were significantly higher than 92.06％,0,0 and 0 of plain X-ray film (P<0.05). The detection rates of bedside high-frequency ultrasound for abdominal effusion,intestinal adhesions and intestinal stenosis in late-stage neonates were 54.55％,22.73％,and 18.18％,which were significantly higher than 0,0,and 0 of plain X-ray film (P<0.05). Conclusion The diagnostic value of bedside high-frequency ultrasound in neonatal necrotizing enterocolitis is high,which can diagnose and judge the severity of neonatal necrotizing enterocolitis early,and timely selection of appropriate treatment options.
Bedside high-frequency ultrasoundPlain X-ray filmNeonatesNecrotizing enterocolitisDiagnostic value
万方数据
维普
