小儿重症急性胰腺炎的超声表现

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目的:总结小儿重症急性胰腺炎(SAP)超声特征及病因。方法:回顾性分析65例经临床确诊或尸检证实为SAP患儿的超声声像特征及临床资料。结果:小儿SAP的超声声像表现:胰腺不同程度的肿大,甚至形态失常,边缘不规整;回声可增强,可减低,或强弱不等;胰周、腹腔各个腔隙积液及假性囊肿形成较多见;原发性SAP胰腺可形态失常,无局限性肿大,回声强弱不等或减低,无回声增强,假性囊肿较多见;继发性SAP(外伤性SAP除外)胰腺无形态失常,可局限性肿大,胰腺回声增强,无回声减低,不伴有假性囊肿。65例SAP中,外伤28例(43.1%),感染18例(27.6%),特发性15例(23.2%),全身性非感染性疾病3例(4.6%),术后应激反应1例(1.5%)。结论:超声能较准确的发现小儿SAP的胰腺声像改变,可协助临床早期诊断和判断病因,从而有效降低患儿的病死率。 Objective: To summarize the echocardiographic features and etiology of infantile severe acute pancreatitis (SAP). Methods: A retrospective analysis of 65 cases of clinically confirmed or autopsy confirmed SAP ultrasound sonographic characteristics and clinical data. Results: Ultrasonography of infants with SAP showed that the pancreas was swollen to varying degrees and even had irregular shape and irregular edges; the echogenicity could be enhanced and could be reduced or the strength varied; Cyst formation is more common; primary SAP pancreas can be morphological disorders, no limitations of the enlarged, unequal or reduced echogenicity, no echo enhancement, pseudocysts are more common; secondary SAP (traumatic SAP except) No morphological disorders of the pancreas, can be limited swelling, enhanced pancreatic echo, no echo reduction, not associated with pseudocyst. There were 28 cases (43.1%) of traumatic injury in SAP, 18 cases (27.6%) of infection, 15 cases (23.2%) of idiopathic and 3 cases (4.6%) of systemic noninfectious diseases in 65 SAP cases. Postoperative stress response 1 Example (1.5%). Conclusion: Ultrasound can more accurately find the changes of pancreatic pancreas in children with SAP, which can help early diagnosis and determine the etiology of SAP, thus effectively reducing the mortality of children.
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