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高频超声在儿童阑尾炎内镜逆行阑尾炎治疗可行性评估中的应用价值。

The application value of high-frequency ultrasound in the feasibility assessment of endoscopic retrograde appendicitis therapy in children with appendicitis.

机构信息

Department of Ultrasound Diagnosis, Tangdu Hospital of Air Force Military Medical University, Xi'an, China.

Department of Ultrasound Diagnosis, The Second Affiliated Hospital of Xi'an Medical College, Xi'an, China.

出版信息

Sci Rep. 2023 Nov 7;13(1):19291. doi: 10.1038/s41598-023-46387-3.

Abstract

Acute appendicitis is one of the common acute abdominal diseases in pediatrics. However, the implementation of radiological examination guided endoscopic retrograde appendicitis therapy (ERAT) in adults is limited in children. Our previous research explored the non-invasive guidance of high-frequency ultrasound (HFUS) for ERAT and achieved good therapeutic effects. This study mainly focuses on exploring the application value of HFUS in the feasibility assessment of ERAT in children with appendicitis. 163 children with appendicitis received ERAT guided by HFUS were analyzed retrospectively. According to the parameters evaluated by HFUS before and during ERAT, the results indicated that the distance between the appendix orifice and the ileocecal valve significantly affected the time required for the guidewire to enter the appendix cavity (P < 0.05). The diameter and the texture of the fecalith, the thickness of the intestinal wall of the appendiceal orifice all had significant effects on the successful removal of the fecalith (P < 0.05). The success rate, treatment time and final flushing effect of the guidewire to reach the blind end of the appendix were significantly affected by the tortuosity of the appendix and whether there was adhesion with surrounding tissues (P < 0.05). HFUS can accurately assess the feasibility of ERAT in children with appendicitis.

摘要

急性阑尾炎是儿科常见的急性腹部疾病之一。然而,在成人中实施放射学检查指导的内镜逆行阑尾炎治疗(ERAT)受到限制。我们之前的研究探索了高频超声(HFUS)在 ERAT 中的非侵入性引导,并取得了良好的治疗效果。本研究主要侧重于探讨 HFUS 在评估阑尾炎患儿 ERAT 可行性中的应用价值。回顾性分析了 163 例接受 HFUS 引导的 ERAT 的阑尾炎患儿。根据 ERAT 前后 HFUS 评估的参数,结果表明,阑尾口与回盲瓣之间的距离显著影响导丝进入阑尾腔所需的时间(P<0.05)。粪石的直径和质地、阑尾口肠壁的厚度均对粪石的成功取出有显著影响(P<0.05)。导丝到达阑尾盲端的成功率、治疗时间和最终冲洗效果均受到阑尾迂曲程度以及是否与周围组织粘连的显著影响(P<0.05)。HFUS 能够准确评估阑尾炎患儿 ERAT 的可行性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5ee4/10630480/bf116f572c1a/41598_2023_46387_Fig1_HTML.jpg

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