Palleri Elena, Kaiser Sylvie, Wester Tomas, Arnell Henrik, Bartocci Marco
Department of Neonatology, Astrid Lindgren Children's Hospital, Stockholm, Sweden.
Department of Pediatric Radiology, Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden.
Eur J Pediatr Surg. 2017 Apr;27(2):161-165. doi: 10.1055/s-0036-1580702. Epub 2016 Mar 28.
The aim of this study was to determine whether a correlation exists between the sonographic findings and the clinical outcomes, defined as surgery or death, in neonates with radiographically and/or histopathologically confirmed necrotizing enterocolitis (NEC). In this retrospective study, the case notes of 58 patients admitted to Karolinska University Hospital, Stockholm, Sweden, with radiographically confirmed NEC from September 2010 to August 2013, were reviewed. We included all newborns who underwent both plain abdominal radiographs and an abdominal ultrasound on the same day. The images were reviewed retrospectively. Patients' characteristics, clinical data, and histopathological data were recorded from the case notes. We excluded newborns who developed free gas before surgery. Abdominal ultrasound images were reviewed for free intraperitoneal gas, peritoneal fluid, pneumatosis intestinalis, portal gas, bowel vascularity, bowel wall thickness, and peristalsis. We correlated the sonographic features with the clinical outcomes; defined as the need for surgery or death. Overall, 25 neonates were included. Out of these, 11 patients underwent surgery and 5 patients died. The sonographic finding of complex fluid collection was statistically significant, predicting severe NEC that needed surgery. No other sonographic features were related to the need for surgery or death. Complex fluid collection shown with abdominal ultrasound appears to be strongly correlated to the need for surgery in newborn infants with severe NEC.
本研究的目的是确定在经影像学和/或组织病理学确诊为坏死性小肠结肠炎（NEC）的新生儿中，超声检查结果与定义为手术或死亡的临床结局之间是否存在相关性。在这项回顾性研究中，我们回顾了2010年9月至2013年8月期间瑞典斯德哥尔摩卡罗林斯卡大学医院收治的58例经影像学确诊为NEC患者的病历。我们纳入了所有在同一天接受了腹部平片和腹部超声检查的新生儿。对图像进行了回顾性分析。从病历中记录患者的特征、临床数据和组织病理学数据。我们排除了在手术前出现游离气体的新生儿。对腹部超声图像进行了检查，以观察腹腔内游离气体、腹腔积液、肠壁积气、门静脉积气、肠血管情况、肠壁厚度和蠕动情况。我们将超声特征与临床结局（定义为是否需要手术或死亡）进行了关联分析。总体而言，共纳入25例新生儿。其中，11例患者接受了手术，5例患者死亡。腹腔内出现复杂液性暗区的超声表现具有统计学意义，可预测需要手术治疗的重症NEC。没有其他超声特征与是否需要手术或死亡相关。腹部超声显示的复杂液性暗区似乎与重症NEC新生儿的手术需求密切相关。
