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目的 探讨新生儿先天性巨结肠不典型X线征群的诊断价值。方法 搜集经手术和病理证实的 36例先天性巨结肠新生儿 ,设为病例组 ;对照组为同期亦经手术和病理证实的 37例非先天性巨结肠新生儿。对他们的腹部平片和钡剂灌肠结果进行对照研究。结果 新生儿先天性巨结肠腹部平片多表现为结肠低位梗阻和肠淤张 (2 3例 ,占 70 % ) ,少部分表现为小肠低位梗阻 (9例 ,占2 7% ) ,与对照组比较差异无显著性意义 (P >0 0 5 )。阴性表现者 1例 ,与对照组比较 ,差异具有显著性意义 (P <0 0 5 )。直肠下端局限性切迹 (13例 )、直肠和下段乙状结肠螺旋形或不规则大锯齿状收缩 (8例 )、2 4h随访钡剂潴留 (18例 )、结肠炎表现 (11例 )、结肠空肠化 (4例 )、钡粪相混征 (18例 )和胎儿型结肠 (6例 )为钡剂灌肠不典型征群。前 3者在病例组和对照组比较 ,差异具有非常显著性意义 (P <0 0 1) ;后 3者差异无显著性意义 (P >0 0 5 )。局限性切迹、直肠和下段乙状结肠螺旋形或不规则大锯齿状收缩、2 4h随访钡剂潴留 3个钡剂灌肠征象对新生儿先天性巨结肠的诊断敏感度分别为 38%、2 4 %、5 3% ;特异度分别为 95 %、10 0 %、78% ;正确指数 (Youden指数 )分别为 0 33、0 2 4、0 31。结论 直肠下端局限性切迹、直肠和下段乙?
Objective To investigate the diagnostic value of atypical X-ray syndrome of neonatal Hirschsprung’s disease. Methods Totally 36 cases of Hirschsprung’s disease were collected and confirmed by operation and pathology. The control group was 37 non-Hirschsprung’s newborns confirmed by surgery and pathology. Their abdominal plain film and barium enema results were controlled study. Results Hirschsprung ’s Hirschsprung’ s abdominal plain film showed low colonic obstruction and intestinal silt (23 cases, accounting for 70%), and small part showed low intestinal obstruction (9 cases, 27%), compared with the control group The difference was not significant (P> 0.05). Negative expression in 1 case, compared with the control group, the difference was significant (P <0 05). (13 cases), serrated or irregular sigmoid constriction in the rectum and lower segment (8 cases), barium retention (18 cases) in 24 hours, colitis (11 cases), colon jejunum (4 cases), barium excrement phase (18 cases) and fetal type colon (6 cases) were barium enema atypical syndromes. The former three in the case group and the control group, the difference was very significant (P <0.01); the latter three had no significant difference (P> 0.05). The limitations of notch, the rectum and lower sigmoid colon spiral or irregular large jagged contraction, 24h follow-up barium retention of 3 barium enema signs of Neonatal Hirschsprung diagnostic sensitivity were 38%, 24% , 53% respectively; the specificity was 95%, 100%, 78% respectively; the correct index (Youden index) was 0 33,0 2 4,0 31 respectively. Conclusion Rectal lower limit notch, rectum and lower segment B?