摘要
目的探讨胃肠超声助显剂在超声诊断胆总管中下段病变中的应用价值。方法选取2009年7月—2013年10月我院收治的183例临床怀疑胆总管中下段病变患者,均行经内镜逆行胰胆管造影(ERCP)、腹腔镜手术或开腹手术。将患者随机分为3组:A组(61例)仅进行常规超声检查;B组(61例)进行常规超声检查+饮温水500ml后超声复查;C组(61例)进行常规超声检查+口服胃肠超声助显剂后超声复查。对比3种超声检查方法的胆总管全程显示率;然后以术后结果为依据,比较3种方法的胆总管中下段病变诊断符合率。结果 A组、B组、C组胆总管全程显示率依次升高〔24.6%(15/61)、59.0%(36/61)、95.1%(58/61),χ2=62.94,P<0.05〕。ERCP、腹腔镜手术或开腹手术证实胆总管中下段结石171例,胆总管下段肿瘤9例,十二指肠壶腹段肿瘤3例;A组、B组、C组胆总管中下段病变诊断符合率依次升高〔62.3%(38/61)、83.6%(51/61)、98.4%(60/61),χ2=26.51,P<0.05〕。结论饮温水或口服胃肠超声助显剂后超声检查均能明显提高胆总管全程显示率及胆总管中下段病变诊断符合率;口服胃肠超声助显剂效果更佳,且具有无辐射、价廉、操作便捷、可重复性强、易被患者接受等优点,具有临床应用价值。
Objective To evaluate the application value of gastrointestinal echogenic contrast agent during the ultra-sonic diagnosis of the middle and lower segment lesions of common bile duct（CBD）. Methods 183 patients with suspected le-sions in the middle and lower segment of CBD admitted to our hospital from July 2009 to October 2013 were given ERCP,laparo-scopic surgery or laparotomy. The patients were randomly divided into three groups：group A（61 cases）,given regular ultra-sound;Group B（61 cases）,given regular ultrasound and re-examination after drinking 500 ml warm water;Group C（61 cases）,given regular ultrasound and re-examination after drinking 500 ml gastrointestinal echogenic contrast agent. The display rates of CBD of three different methods were analyzed. Based on the postoperative results,the coincidence rates of three different methods in the diagnosis of middle and lower segment lesions of CBD were analyzed and compared. Results The display rates of CBD of group A,group B and group C were 24. 6%（15/61）,59. 0%（36/61）and 95. 1%（58/61）respectively（χ2 =62. 94,P〈0. 05）. 171 cases were confirmed with stone in the middle and lower segment of CBD,9 cases were confirmed with tumor in the lower segment of CBD and 3 cases were confirmed with tumor of duodenal ampulla. The diagnostic coincidence rates of group A,group B and group C were 62. 3%（38/61）,83. 6%（51/61）and 98. 4%（60/61）respectively（χ2 =26. 51,P〈0. 05）. Conclusion Ultrasound examination after drinking warm water or oral gastrointestinal echogenic contrast agent can obviously increase the display rate of CBD and ultrasound diagnosis coincidence rate of the middle and lower segment of CBD. The effect of oral gastrointestinal echogenic contrast agent is much better. It has advantages of low price,convenient operation,no ra-diation,strong repeatability and can be easily accepted by patients. It has important clinical value.
出处
《中国全科医学》
CAS
CSCD
北大核心
2014年第24期2901-2904,共4页
Chinese General Practice
关键词
胃肠超声助显剂
超声检查
饮水
胆总管
诊断
Gastrointestinal echogenic contrast agent
Ultrasonography
Drinking
Common bile duct
Diagnosis
作者简介
通信作者：张卫兵，225003江苏省扬州市，武警江苏省总队医院超声影像中心；E—mail：15062856886@163．com
