目的 探讨高频超声对小儿梅克尔憩室所致肠梗阻的诊断价值。方法 选取广州市妇女儿童医疗中心2018年1月—2023年12月经手术证实的由梅克尔憩室引起的肠梗阻患儿41例作为研究对象,回顾性分析患儿临床资料及超声表现,并与术中所见和病理结果进行对照。结果 41例患儿,发病平均年龄为（3.97±3.69）岁,其中男32例、女9例。术前超声诊断肠梗阻38例,诊断符合率为92.7%;诊断梅克尔憩室所致肠梗阻9例,诊断符合率为21.9%。术中诊断梅克尔憩室索带卡压肠管24例,腹内疝8例,肠扭转1例;肠套叠10例;梅克尔憩室炎症、粘连6例,粘连穿孔1例;憩室内异物并穿孔1例。结论 高频超声对小儿肠梗阻有重要的诊断价值,仔细探查可以明显提高梅克尔憩室所致肠梗阻的临床诊断率,为临床尽早手术提供重要依据。

Objective To investigate the diagnostic value of high frequency ultrasound for intestinal obstruction caused by Meckel's diverticulum in children．Methods From January 2018 to December 2023,41 children with intestinal obstruction caused by Meckel's diverticulum were selected as the study objects．The clinical data and ultrasound images of the children were analyzed retrospectively,and compared with the intraoperative and pathological results．Results In 41 patients,the average age of onset was（3.97±3.69）years ,including 32 males and 9 females．Preoperative ultrasonic diagnosis of intestinal obstruction in 38 cases,diagnosis coincidence rate was 92.7%．Intestinal obstruction caused by Meckel's diverticulum was diagnosed in 9 cases,the diagnosis coincidence rate was 21.9%．During the operation,24 cases of Meckel's diverticulum intestinal compression were diagnosed,8 cases of abdominal hernia,1 case of intestinal torsion,and intussusception of 10 cases．Meckel's diverticulum had inflammation and adhesion in 6 cases and adhesion perforation in 1 case．A case of foreign body in diverticulum with perforation．Conclusions High-frequency ultrasound has an important diagnostic value for intestinal obstruction in children．Careful exploration can significantly improve the clinical diagnosis rate of intestinal obstruction caused by Meckel's diverticulum,and provide an important basis for early clinical operation．

目的 探究超声检查对于甲状腺囊性结节随访中的作用和临床价值,探讨其临床应用意义。方法 以2018年1月—2019年1月在本院就诊,经过临床金标准诊断为甲状腺囊实性结节的83名患者作为研究对象,采用历史性队列研究方法对患者进行为期18个月的随访观察,对患者在随访期内,使用超声检查所得知的甲状腺囊实性结节的大小、形态、边界、内部回声、钙化及血流信号等特征进行记录,并与患者初次就诊时的记录进行对比分析。结果 根据随访记录得知,83例患有甲状腺囊实性结节的患者当中,75例患者在随访后发现具有甲状腺恶性结节症,其余8例患者不具有甲状腺恶性结节特征。随访后83例患者的甲状腺囊实性结节均呈现好转,主要表现为:甲状腺囊实性结节出现不同程度的吸收;结节体积减小,个数无变化;结节吸收后在超声下显示在同一部位的结节表现为低或极低回声结节;囊性液体成分明显减少,部分原结节较小的患者,囊性成分出现消失。根据对随访前后患者甲状腺囊实性结节的平均体积对比有统计学差异(P<0.05),随访后的结节半径明显小于随访前。甲状腺囊实性结节体积有效缩小率为68%～88%。结论 通过对甲状腺囊实性结节定期进行超声复查可以实现对甲状腺结节的动态观察,有助于对患者的病情进行掌握,且由于甲状腺囊实性结节患者在后期结节吸收过程中常常出现恶性结节特征。通过使用超声检查对患者进行长期随访不仅可起到早期诊断甲状腺恶性肿瘤的意义,还可以避免,因过度诊断为甲状腺恶性结节,而使用细胞穿刺检查等有创检查对患者造成的不便。