本文選題：“胡桃夾”現(xiàn)象　切入點(diǎn)：兒童　出處：《重慶醫(yī)科大學(xué)》2017年碩士論文　論文類型：學(xué)位論文

【摘要】：研究目的:探討“胡桃夾”現(xiàn)象在正常兒童人群中出現(xiàn)的百分比及臨床意義。材料與方法:回顧性分析2012年1月至2016年3月在重慶醫(yī)科大學(xué)附屬兒童醫(yī)院放射科因非腎臟相關(guān)疾病行腹部CT血管造影(Computed Tomographic Angiography,CTA)檢查的住院兒童影像及臨床資料,共246例,男131例,女115例;年齡范圍1月~13.0歲,平均年齡(4.94±3.48)歲;所有兒童均除外左腎及左腎靜脈相關(guān)疾病與變異,除外腹膜后占位性病變,尿常規(guī)檢查未見異常。按年齡分為7組:嬰兒期(1月~1.0歲)為1組,其它1.0~13.0歲兒童以兩歲為間隔分為6組。在CTA圖像上,同時具備以下兩個條件時判定為“胡桃夾”現(xiàn)象:腹主動脈與腸系膜上動脈之間的夾角(Aortomesenteric Angle,AMA)45°;左腎門部左腎靜脈最寬處內(nèi)徑(D2)和腹主動脈與腸系膜上動脈間左腎靜脈受壓處內(nèi)徑(D1)之比大于或等于3。分析“胡桃夾”現(xiàn)象在正常兒童人群出現(xiàn)的百分比,以及AMA的變化。結(jié)果:246例中,34例(13.82%)出現(xiàn)“胡桃夾”現(xiàn)象,嬰兒組出現(xiàn)百分比為0%,余下各組百分比依次為5.77%(3/52),12.20%(5/41),16.67%(8/48),18.75%(6/32),23.81%(5/21),28.00%(7/25),各年齡組“胡桃夾”現(xiàn)象出現(xiàn)的百分比存在顯著的等級趨勢性增高差異(χ2=13.879,P0.01),年齡越大出現(xiàn)百分比相對越高,而AMA隨年齡的增大逐漸變小。結(jié)論:“胡桃夾”現(xiàn)象在正常兒童人群出現(xiàn)的百分比約為13.82%,隨年齡有增長趨勢,該現(xiàn)象可以作為一種正常的解剖變異出現(xiàn)在一部分正常兒童中,正確認(rèn)識這一現(xiàn)象可避免將其過度診斷為“胡桃夾”綜合征。
[Abstract]:Objective: to explore the percentage and clinical significance of "Nutcracker" phenomenon in normal children. Materials and methods: retrospective analysis was conducted from January 2012 to March 2016 in the Department of Radiology, Children's Hospital affiliated to Chongqing Medical University. The imaging and clinical data of hospitalized children with non-renal related diseases were examined by computed Tomographic angiography. A total of 246 cases, male 131 and female 115, were aged from January to January, with an average age of 4.94 鹵3.48 years. All children were excluded from left kidney and left renal vein related diseases and variations, except for retroperitoneal space occupying lesions. Urine routine examination was not abnormal. It was divided into 7 groups according to age: group 1 in infancy (January, 1. 0 years old), and 6 groups in other children aged 1. 0 to 13. 0 years old. On CTA images, 6 groups were divided into 6 groups. "Nutcracker" is determined as a "nutcracker" phenomenon when the following two conditions are satisfied: the angle between the abdominal aorta and the superior mesenteric artery, Aortomesenteric Anglean AMA-45 擄; the left renal vein at the widest point of the left hilar; and the left kidney rest between the abdominal aorta and the superior mesenteric artery, and between the abdominal aorta and the superior mesenteric artery. The ratio of diameter D _ 1 to D _ 1 was greater than or equal to 3. The percentage of "nutcracker" phenomenon in normal children was analyzed. And the change of AMA. Results the "nutcracker" phenomenon appeared in 34 out of 246cases. The percent in the infant group was 0, and the percentage for the rest of the group was 5.77 / 52 / 12.20 and 5 / 45 / 41, 16.67 / 848 / 18.75% respectively. There was a significant trend increase in the percentage of "walnut clamp" in all age groups (蠂 ~ 2 / 13.879), the higher the percentage, the higher the relative percentage of the "walnut clamp" in all age groups (蠂 ~ 2 / 13.879, P 0.01). Conclusion: the percentage of "nutcracker" in normal children is about 13.82, and it has an increasing trend with age. It can be seen as a normal anatomical variation in some normal children. The correct understanding of this phenomenon can avoid the over-diagnosis of Nutcracker syndrome.
【學(xué)位授予單位】：重慶醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R816.92;R726.9

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