NECROTIZING ENTEROCOLITIS - VALUE OF RADIOGRAPHIC FINDINGS TO PREDICT OUTCOME
NECROTIZING ENTEROCOLITIS - VALUE OF RADIOGRAPHIC FINDINGS TO PREDICT OUTCOME
复制标题
DOI：
10.2214/ajr.151.4.771
复制
发表时间：
1988-10-01
影响因子：
5
通讯作者：
BHATTACHARYYA, N
中科院分区：
文献类型：
--
作者：
KOSLOSKE, AM;MUSEMECHE, CA;BHATTACHARYYA, N
我们回顾了147例坏死性小肠结肠炎的系列腹部X线片和临床记录，以探讨是否可以用放射学结果来预测泛坏死(75%或以上的空肠、回肠和结肠的坏死)。29例(20%)婴儿发生泛坏死，且总是致命的。观察肠气、气腹、门静脉气体的存在及程度。在轻度或中度肠气肿的婴儿中，泛坏死的发生率最低(分别为8%和12%)，而在气腹的婴儿中，泛坏死的发生率中等(33%)。重度肠气肿(56%)、门静脉气肿(61%)或合并门静脉气肿(79%)的婴幼儿常出现泛坏死。三组死亡率分别为63%、655和86%。因此，通过检测严重的肠气肿和门静脉气体，可以在平片上确定预后最差的婴儿(发展为泛坏死者)。
To investigate whether radiographic findings could be used to predict pan-necrosis (necrosis of 75% or more of the jejunum, ileum, and colon), we reviewed the serial abdominal radiographs and clinical records of 147 infants with necrotizing enterocolitis. Pan-necrosis occurred in 29 infants (20%) and was always fatal. The presence and degree of pneumatosis intestinalis, pneumoperitoneum and portal venous gas were studied. Pan-necrosis occurred least frequently in infants with mild or moderate pneumatosis intestinalis (8% and 12%, respectively), and with moderate frequency in those with pneumoperitoneum (33%). Pan-necrosis was found most frequently in infants with severe pneumatosis intestinalis (56%), portal venous gas (61%), or the combination of severe pneumatosis intestinalis and portal venous gas (79%). The mortality rates in these three groups were 63%, 655, and 86%, respectively. Thus, infants with the worst outcome (those who develop pan-necrosis) can be identified on plain films by detection of severe pneumatosis intestinalis and portal venous gas.