Okada T, Yoshida H, Iwai J, Matsunaga T, Ohtsuka Y, Kouchi K, Tanabe M, Ohnuma N
Department of Pediatric Surgery, Chiba University, School of Medicine, Chiba, Japan.
J Pediatr Surg. 2001 Mar;36(3):430-5. doi: 10.1053/jpsu.2001.21602.
BACKGROUND/PURPOSE: This study was undertaken to assess the usefulness of pulsed Doppler sonography (PDS) for the detection of strangulation in small bowel obstruction by evaluating the hemodynamics in the superior mesenteric artery (SMA).
The authors performed PDS in 117 normal children: 22 children aged 0 to 1 months (group I), 27 children aged 1 to 12 months (group II), 36 children aged 1 to 6 years (group III), and 32 children aged 7 to 15 years (group IV). Patients included 25 with simple obstruction: 1 in group II, 10 in group III, and 14 in group IV; and 9 with strangulating obstruction: 2 in group I, 2 in group II, 3 in group III, and 2 in group IV. The authors measured the peak-systolic velocity, end-diastolic velocity (EDV), and mean average velocity and calculated the resistive index (RI).
The authors observed both a significant decrease in the EDV and increase in the RI for the SMA in strangulating obstruction compared with simple obstruction.
Analysis of the hemodynamics in the SMA using PDS is useful to differentiate strangulating obstruction from simple obstruction.
背景/目的：本研究旨在通过评估肠系膜上动脉（SMA）的血流动力学，探讨脉冲多普勒超声检查（PDS）在检测小肠梗阻绞窄方面的实用性。
作者对117名正常儿童进行了PDS检查：22名0至1个月大的儿童（I组），27名1至12个月大的儿童（II组），36名1至6岁的儿童（III组），以及32名7至15岁的儿童（IV组）。患者包括25例单纯性梗阻：II组1例，III组10例，IV组14例；9例绞窄性梗阻：I组2例，II组2例，III组3例，IV组2例。作者测量了收缩期峰值流速、舒张末期流速（EDV）和平均流速，并计算了阻力指数（RI）。
作者观察到，与单纯性梗阻相比，绞窄性梗阻时SMA的EDV显著降低，RI升高。
使用PDS分析SMA的血流动力学有助于区分绞窄性梗阻和单纯性梗阻。
