Page 66 - 南京医科大学学报自然科学版

南京医科大学学报（自然科学版） 第44卷第1期
· 60 · Journal of Nanjing Medical University（Natural Sciences） 2024年1月

·临床研究·

超声联合放射学在新生儿胎粪性腹膜炎治疗方式评估中的价值

方玉香 ，花立春 ，陈 俊 ，刘 慧 ，黄亚青 ，谢 华 ，唐 颖 1*
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南京医科大学附属儿童医院超声诊断科，放射科，新生儿外科，江苏 南京 210008
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［摘 要］ 目的：探讨超声联合放射学检查在新生儿胎粪性腹膜炎诊断及治疗方式选择中的作用。方法：回顾性分析2018年
1月—2022年12月共83例确诊胎粪性腹膜炎的新生儿临床、超声以及放射学表现和治疗结果。将所有患儿分为手术组和非
手术组，对超声和X线片出现的腹腔钙化、胎粪假性囊肿、肠梗阻、肠扭转、腹水和气腹等表现进行统计分析。结果：共83例新
生儿（男 48 例，女 35 例）确诊为胎粪性腹膜炎，所有病例入院后均行超声及 X 线检查，其中 61 例（73.5%）需手术治疗，22 例
（26.5%）未手术，经对症保守治疗好转出院。手术组肠梗阻（超声 24/61，放射 32/61）、腹水（超声 27/61）、肠扭转（超声 13/61）
3 种影像表现出现比例均高于非手术组，差异有统计学意义（P < 0.05），手术组气腹征象也高于非手术组，但数量较少，差异无
统计学意义。手术组的弥漫性腹腔钙化、胎粪性假性囊肿占比与非手术组差异无统计学意义。结论：影像学表现中肠梗阻、腹
水、肠扭转和气腹等征象高度提示需要手术治疗，仅存在腹腔多发钙化灶影像表现的新生儿可保守治疗，胎粪性假性囊肿患儿
如不合并上述几种表现不需要手术治疗。
［关键词］ 新生儿；胎粪性腹膜炎；超声；放射学
［中图分类号］ R722.13 ［文献标志码］ A ［文章编号］ 1007⁃4368（2024）01⁃060⁃06
doi：10.7655/NYDXBNSN230679

Value of ultrasonography combined with radiology in the evaluation of treatment methods
for meconium peritonitis in newborns

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FANG Yuxiang ，HUA Lichun ，CHEN Jun ，LIU Hui ，HUANG Yaqing ，XIE Hua ，TANG Ying 1*
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1 Department of Ultrasound，Department of Radiology，Department of Neonatal Surgery，the Affiliated Children’s
Hospital of Nanjing Medical University，Nanjing 210008，China
［Abstract］ Objective：To explore the value of imaging in the diagnosis of neonatal meconium peritonitis and the selection of
treatment methods. Methods：We retrospectively analyzed the clinical，ultrasound and radiological manifestations and treatment
results of 83 neonates，which were diagnosed as meconium peritonitis，from January 2018 to December 2022. The children were
divided into the surgical group and the non ⁃ surgical group，and the manifestations on ultrasound and X ⁃ ray examination such as
peritoneal calcification，meconium pseudocyst，intestinal obstruction，volvulus，ascites，and pneumoperitoneum were analyzed. Results：
Eighty three neonates（48 males and 35 females）were diagnosed as meconium peritonitis in this period. All patients received
ultrasound and X⁃ray examination after admission. Among them，61 cases（73.5%）required surgical treatment，and 22 cases（26.5%）
were successfully treated non ⁃ surgically. The occurrence rates of three imaging manifestations，including intestinal obstruction
（ultrasound 24/61，radiography 32/61），ascites（ultrasound 27/61），and intestinal torsion（ultrasound 13/61），were higher in the
surgical group than the non⁃surgical group（P < 0.05）. The presence of pneumoperitoneum signs in the surgical group was also higher
than the non⁃surgical group，but the number of cases was not enough to show statistical significance. There was no statistical difference
in the proportion of multiple calcifications and meconium pseudocysts between two groups. Conclusion：Imaging findings that
predicted the need for surgery were intestinal obstruction，ascites，volvulus and pneumoperitoneum. Neonates only with multiple
calcifications in the peritoneum can be successfully treated non⁃operatively. Children with meconium pseudocyst do not need surgery if
they do not have the above manifestations.
［Key words］ neonate；meconium peritonitis；ultrasound；radiology
［J Nanjing Med Univ，2024，44（01）：060⁃064，144］

［基金项目］ 南京市卫生科技发展专项资金项目（YKK19106）；南京医科大学科技发展基金面上项目（NMUB20220023）
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通信作者（Corresponding author），E⁃mail：tangying1299@163.com