腹型紫癜患儿临床诊断中高频超声的应用意义.docVIP

腹型紫癜患儿临床诊断中高频超声的应用意义  　　摘要：　目的 回顾性分析已确诊的50例腹型紫癜患儿肠道超声表现，探讨高频超声对儿童腹型紫癜诊断临床价值，提高临床诊断率。方法 应用高频探头进行腹部超声检查，重点观察各段肠管肠壁厚度、回声及其周围淋巴结、肠系膜回声的变化，观察肠壁的血供情况。结果 50例患儿46例超声提示腹型紫癜，超声见肠壁均有不同程度节段性或广泛性向心性全层增厚、回声减低，呈面包圈;样改变，以黏膜下层增厚为主，CDFI：受累肠管肠壁血流丰富。肠壁损害部位多发生在小肠。1例继发肠套叠，36例出现腹腔积液、肠系膜淋巴结增大及肠系膜回声增强等伴随症状。结论肠壁向心性全层增厚、回声减低，以黏膜下层增厚为主，肠管横断呈面包圈;样改变为腹型紫癜的特异性超声表现，识别该特征对及早诊断该病具有重要的作用。 　　关键词：　高频超声; 紫癜; 过敏性; 儿童; 肠壁增厚; 　　Abstract：　Objective We retrospectively analyzed the confirmed intestinal ultrasound findings of 50 children with abdominal purpura and explored the clinical value of high-frequency ultrasound in the diagnosis of children abdominal purpura,aiming to improve the clinical diagnosis rate.Methods High-frequency probe was used for abdominal intestinal ultrasound examinationhe thickness of intestinal wall,echo,its surrounding lymph nodes and mesenteric echo were observed carefully,together with blood supply of intestinal wall.Results The intestinal wall of 46 children with abdominal purpura had different degrees of segmental or extensive thickening,and echo reduction,showing a bread ring;-like change and a mainly thickened submucosal layer.CDFI showed abundant blood flow in intestinal wall.Intestinal wall damage occurs mostly in the small intestine.One patient had secondary intussusception,and 36 patients had associated symptoms such as ascites,mesenteric lymph node enlargement and mesenterium thickening and echogenic.Conclusion High-frequency ultrasound has specific ultrasound findings on abdominal purpura,for example,the centripetal thickening of whole intestinal wall,the echo reduction,the dominant submucosal thickening and the intestinal transection with abread ring;-like change.Identifying these features plays an important role in early diagnosis of the disease. 　　Keyword：　high-frequency ultrasound; purpura; schoenlein-henoch; children; thickening of the intestinal wall; 　　过敏性紫癜是儿童期比较常见的毛细血管变态反应性疾病，属于过敏性血管炎，据统计每年儿童发病率约（8-20）/10万，并有逐年增加的趋势。表现血小板不减少性紫癜，累及消化道被称为腹型紫癜。腹型紫癜消化道症