Schmidt H, Keller K M, Schumacher R
Kinderklinik, Johannes-Gutenberg-Universität, Mainz.
Rofo. 1991 Jul;155(1):32-7. doi: 10.1055/s-2008-1033214.
Clinical data and radiographic findings of 32 newborn suffering from necrotising enterocolitis were analysed [12 patients with rotavirus-positive necrotising enterocolitis (RV + NEC), 20 patients with rotavirus-negative necrotising enterocolitis (RV-NEC)]. The presence and degree of pneumatosis intestinalis, portal venous gas and pneumoperitoneum on abdominal radiographs were graded after Kosloske et al. according to "mild, moderate, and severe". Pneumatosis intestinalis occurred twice as often in the ascending colon in RV-NEC compared to RV + NEC, whereas the transverse colon was involved nearly as frequently as the descending colon in both groups. Portal venous gas was present in 10% of the cases with RV-NEC and was absent in RV + NEC. Pneumoperitoneum only occurred in 8% of RV + NEC but in 20% of RV-NEC. Radiographic findings are helpful in the differentiation between both groups of NEC. Conservative therapy is preferable especially in mainly distal colon distribution of pneumatosis intestinalis without pneumoperitoneum.
对32例坏死性小肠结肠炎新生儿的临床资料和影像学检查结果进行了分析[12例轮状病毒阳性坏死性小肠结肠炎(RV + NEC),20例轮状病毒阴性坏死性小肠结肠炎(RV - NEC)]。腹部X线片上肠壁积气、门静脉积气和气腹的存在及程度按照科斯洛斯基等人的方法分为“轻度、中度和重度”。与RV + NEC相比,RV - NEC中升结肠肠壁积气的发生率是其两倍,而两组中横结肠受累的频率与降结肠相近。10%的RV - NEC病例出现门静脉积气,而RV + NEC病例未出现。气腹仅在8%的RV + NEC病例中出现,但在20%的RV - NEC病例中出现。影像学检查结果有助于区分两组坏死性小肠结肠炎。保守治疗更可取,尤其是在肠壁积气主要分布于结肠远端且无气腹的情况下。