上消化道气钡双重造影和胃镜对食管裂孔疝的诊断价值

目的探讨上消化道气钡双重造影和胃镜检查对食管裂孔疝的诊断价值。方法对100例手术后诊断为食管裂孔疝的患者进行回顾性分析。100例均行上消化道气钡双重造影、胃镜检查,在对两种检查结果进行对比分析。结果上消化道气钡双重造影检查出食管裂孔疝96例,未发现食管裂孔疝4例,胃镜检查出食管裂孔疝38例,未发现62例,胃镜检查出反流性食管炎61例。结论上消化道气钡双重造影对食管裂孔疝的诊断价值优于胃镜,可作为临床首选检查。     

胃恶性溃疡双重造影与标本涂钡X线照片对比分析

胃恶性溃疡是消化道常见疾病之一,术前正确诊断对治疗方法的选择与预后关系重大,术前诊断大多依靠纤维胃镜,但X线检查(气钡双重造影)[1,2]仍是一种重要检查方法。笔者采集术后标本涂钡后进行X线照片,选取质量优良、资料完整、经病理证实的20例胃恶性溃疡患者的双重造影片和标本     

X线、CT和消化内镜对克罗恩病诊断价值的评价

目的 探讨X线、CT及消化内镜对克罗恩病的诊断价值及其限度.方法 回顾性分析经病理、肠镜、手术证实的66例克罗恩病患者X线、CT及消化内镜表现,其中X线小肠+结肠气钡双造影36例,窦道造影28例,全腹部CT平扫+增强54例,消化内镜检查46例,同时行X线小肠+结肠气钡造影和腹部窦道造影18例,行X线小肠+结肠气钡造影和CT检查24例,行 X线小肠+结肠气钡造影和消化内镜检查22例,行CT和消化内镜检36例.结果 36例小肠+结肠气钡双造影中,多节段性病变24例(66.7%),多发性、纵行裂隙状溃疡17例(47.2%),卵石征16例(44.4%),肠瘘4例(11.1%),X线气钡双造影未显示肠壁增厚及腹腔脓肿、炎性包块等肠外并发症,对肠瘘的显示率亦不高.28例腹部窦道造影中,肠瘘20例(71.4%),腹腔脓肿形成16例(57.1%),窦道形成12例(42.8%).54例CT检查,表现为肠壁增厚(＞4 mm)46 例( 85.2%),强化增加(＞20～30 HU) 42例(77.8%),多节段性病变 39例(72.2%),肠腔不规则狭窄38例(70.4%),系膜区淋巴结肿大(＞5 mm)18例( 33.3%),系膜区血管束增多、增粗14例(25.9%),肠管周围蜂窝织炎21例(38.9%),腹腔内脓肿16例(29.6%),炎性包块14例(25.9% ),不全性肠梗阻22例(40.7%),腹腔积液36例(66.7%),瘘管形成8例(14.8% ),CT未显示肠壁线形溃疡和卵石征,对肠瘘的显示率不高.46例消化内镜检查中,纵行裂隙状溃疡26例(56.5%),铺路石样卵石征28例(60.8%),肠腔不规则狭窄36例(78.3%),多节段性病变34例(73.9%),消化内镜未显示肠壁及肠外并发症等病症.结论 X线小肠+结肠气钡造影,腹部窦道造影及CT 3种检查方法相互结合,对于克罗恩病的临床诊断及综合治疗具有重要价值.     

气钡双重造影在上消化道疾病诊断中的应用

目的：探讨气钡双重造影X线检查在上消化道疾病诊断中的价值。方法对2014年5月～2015年4月收治的79例上消化道疾病患者的医学影像资料进行分析探讨。结果经检查，发现黏膜病变（炎症、癌症和溃疡）共38例；发现黏膜下病变（间质瘤、淋巴瘤、硬皮病）20例；器官结构改变（食管裂孔疝、憩室）16例。结论气钡双重造影X线检查是一种有效诊断手段，精度高，患者不适感少，可在临床进行推广。     

青海高原消化性溃疡出血相关因素临床探讨

消化性溃疡(ＰｅｐｔｉｃＵｌｃｅｒ,ＰＵ)是上消化道出血(ＵｐｐｅｒＧａｓｔｒｏｉｎｔｅｓｔｉｎａｌＨｅｍｏｒｒｈａｇｅ,ＵＧＨ)的常见病。为探讨高原地区的ＰＵ出血的原因,本文对我院经胃镜检查确诊为消化性溃疡出血病例376例进行分析,从临床角度探讨其与季节、性别等因素的相关关系。1　临床资料11　病例来源　1994年10月～1998年10月在我院就诊经胃镜确诊为胃十二指肠溃疡者共376例,溃疡直径在3～25ｍｍ,并具有呕血或黑便病史。所有病例检查均由同一专职内镜医师完成。排除因肿瘤、肝硬化、出血性胃炎等非消化性溃疡引起的出血。12…     

影像学检查对胃肠道间质瘤诊断价值的临床分析

目的探讨胃肠道间质瘤的影像学诊断价值。方法对11例经手术病理确诊的胃肠道间质瘤进行回顾性分析。10例行胃肠道气钡双重造影,4例行CT检查,2例行肠系膜上动脉造影,7例行电子纤维内镜检查。结果肿瘤位于胃部7例,小肠2例,食管上段及食管下段至贲门各1例。病灶检出率:胃肠道气钡双重造影100%,CT检查75%,肠系膜上动脉造影100%,内窥镜检查100%。结论气钡双重造影和内窥镜检查是胃肠道间质瘤筛选的重要方法,CT检查和动脉血管造影对胃肠道间质瘤向腔外生长型定位及判断良恶性有一定价值。     

早期胃癌的X线诊断价值探讨

目的：探讨早期胃癌X线气钡双重造影的影像表现，提高对早期胃癌的影像学认识和诊断水平。材料与方法：搜集25例经我院手术及病理证实为早期胃癌的患者，其中男18例，女7例，年龄38－65岁，25例均行上消化道气钡双重造影检查。结果：9例为I型（隆起型），10例为Ⅱ型（浅表型，6例为Ⅲ型（凹陷型）。结论：充分利用X线气钡双重造影影像表现有助于早期胃癌的诊断。     

胃底贲门癌的X线钡餐造影诊断

目的总结胃底贲门癌的X线特征性表现。方法 20例由手术病理证实的胃底贲门癌患者(男性12例,女性8例,年龄45～72岁)均经X线钡餐造影检查,包括气钡双重造影和气腹胃壁造影,回顾性分析了所有患者的影像表现。结果病变部位黏膜增粗、紊乱、中断消失占100%,胃泡内软组织肿块占60%,胃底僵硬变形占80%,恶性龛影占70%,食管下端变窄及钡流喷射现象占60%。结论胃底贲门癌患者采用X线上消化道钡餐造影检查安全可靠,准确率高,同时可以弥补胃镜对容易遗漏的死角及功能性变化观察的不足。     

上消化道钡餐透视结果分析

1临床资料1.1一般资料目前临床在上消化道钡餐透视时多使用气钡双重法。回顾性随机抽取我院2008年1～8月经上消化道钡餐透视有随访资料的患者资料100例,患者年龄8～78岁,平均55.74岁。这些患者中无明显溃疡病史并且临床不怀疑肿瘤疾病并且年龄在50岁以下的均采用普通法。而对于年龄偏大，普通法对黏膜显示欠佳．并且临床怀疑溃疡或肿瘤疾病的患者均使用了气钡双重法。     

复合性溃疡98例分析

自2004-2008年上消化道内镜检查中检出消化性溃疡1 205例,其中复合性溃疡98例,占同期胃镜确诊的消化性溃疡总数8.1%。现将资料总结分析如下。 1临床资料1.1一般资料经胃镜活检及手术病理确诊98例复合性溃疡中,男性76例,女性22例,年龄22-68岁,40岁以下者62例,占63.2%。     

Significance of Helicobacter pylori infection and nonsteroidal anti-inflammatory drugs in patients with bleeding from upper part of the gastrointestinal tract

BACKGROUND/AIM: Helicobacter pylori (H. pylori) infection and nonsteroidal anti-inflammatory drugs (NSAIDs) use are considered to be the most important risk factors having influence on the onset of bleeding gastroduodenal lesions. Whether there is an interaction between H. pylori infection and the use of NSAIDs in the development of peptic ulcer disease is still controversial. The aim of the present study was to evaluate the prevalence of NSAIDs use and H. pylori infection in patients presented with bleeding gastroduodenal lesions. METHODS: During the period from January 2003 December 2003 we prospectively obtained data of all the patients (n=106) presented with signs of upper gastrointestinal bleeding. All the patients were admitted to the intensive care unit, with the endoscopy performed within 12 hours after admission. Histologic analysis was used for the detection of H. pylori infection. The NSAIDs and aspirin use data were obtained by anamnesis. RESULTS: The results of our study revealed that the most common sources of upper gastrointestinal bleeding were duodenal (57 patients, 53.77%) and ventricular (36 patients, 33.96%) ulcers. The majority of the examined cases were associated with both H. pylori infection and NSAIDs use. A statistically significant difference among the studied groups of patients was proven. CONCLUSION: The majority of bleeding gastroduodenal lesions were associated with the coexistance of H. pylori infection and NSAIDs use, while their independent influences were statistically less important. Eradication of H. pylori infection in patients using NSAIDs might prevent upper gastrointestinal hemorrhage and reduce peptic ulcer bleeding risk.     

非甾体抗炎药致消化性溃疡出血临床分析

为研究非甾体抗炎药（NSAIDs）致消化性溃疡出血的临床特征。笔者对解放军第210医院消化性溃疡出血住院患者的临床资料按照出血前10天内是否服用过NSAIDs分为两组进行比较。结果显示,262例消化性溃疡出血患者中有18．32％服用过NSAIDs。两组患者的性别、消化性溃疡史、出血程度、病变大小及部位比较无显著性差异（P＞0．05）,但NSAIDs 组患者的年龄偏大,较多患者有消化道出血史、心血管病史,出血前消化道症状不明显,溃疡更易多发,平均住院天数明显减少（P＜0．05）。     

Evaluation of technetium-99m DTPA for localization of site of acute upper gastrointestinal bleeding

Intravenous Tc-99m DTPA was evaluated in 34 patients with active upper gastrointestinal bleeding. Active bleeding was detected in 25 patients: nine in the stomach, 12 in the duodenum, and four from esophageal varices. No active bleeding was seen in nine patients (two gastric ulcers and seven duodenal ulcers). Results were correlated with endoscopic and/or surgical findings. All completely correlated except: 1) one case of esophageal varices in which there was disagreement on the site, 2) three cases of duodenal ulcers that were not bleeding on endoscopy but showed mild oozing on delayed images and 3) one case of gastric ulcer, in which no bleeding was detected in the Tc-99m DTPA study, but was found to be bleeding at surgery 24 hours later. The Tc-99m DTPA study is a reliable method for localization of upper gastrointestinal bleeding with an agreement ratio of 85%. This method also can be used safely for follow-up of patients with intermittent bleeding. It is less invasive than endoscopy, is easily repeatable, and has the same accuracy.     

Technetium 99m-labelled-sucralphate isotope scanning in the detection of peptic ulceration

An isotope scan using sucralphate labelled with technetium-99m has been compared with barium meal in the detection of peptic ulceration in 18 patients with endoscopically proven upper gastrointestinal lesions and eight controls. Gastric (75%) and duodenal (67%) ulcers were detected with identical frequency by isotope scan and barium meal but both were inferior to endoscopy. Structural, non-ulcerated lesions, were not identified by isotope scanning. The scan has potential value in duodenal ulcer disease, the serial assessment of ulcer healing and in paediatric gastroenterology.     

Heterotopic gastric mucosa in the duodenal bulb: relationship to peptic ulcer

Heterotopic gastric mucosa in the duodenal bulb causes a characteristic radiologic abnormality consisting of multiple small, well-defined nodules in the mucosa. This finding was identified in 92 (5%) of 1873 consecutive standard biphasic barium examinations of the upper gastrointestinal tract. Of these 92, only one patient (1%) had an associated duodenal ulcer as compared with the other 1781 patients without heterotopic gastric mucosa of whom 225 (13%) had duodenal ulcers or scars (p = .002). No gastric ulcers or ulcer scars were identified in the patients with heterotopic gastric mucosa, whereas ulcers or scars were identified in 88 patients (5%) without heterotopic gastric mucosa (p = .05). These data raise the possibility that heterotopic gastric mucosa protects against peptic ulceration.     

上消化道出血病因分析及临床护理简

目的：探究上消化道出血病因及临床护理,为临床治疗提供参考。方法选择在本院治疗的370名上消化道出血的患者为研究对象,通过对比分析上消化道出血患者的临床资料,探究上消化道出血的病因及临床护理,为日后临床治疗及护理提供帮助。结果男女之比为1.4：1,在本次研究中,消化性溃疡183例（49.5%）,急性胃黏膜损伤出血94例（25.4%）,食管胃底静脉曲张破裂56例（15.1%）,恶性肿瘤21例（5.7%）,食管贲门黏膜撕裂症11例（3.0%）,血管畸形5例（1.4%）。其中消化性溃疡的病因最常见,差异有统计学意义（P＜0.05）。结论消化性溃疡、急性胃黏膜病变、食管胃底静脉曲张破裂以及恶性肿瘤是引起上消化道出血的常见病因,其中消化性溃疡为最常见的病因。此外,及时采取正规的护理能有效地控制上消化道出血。     

表皮生长因子及其对胃肠道黏膜的作用

本文综述了表皮生长因子(epidermal growth factor，EGF)的结构、性质、生理作用、合成部位及消化道内EGF的来源，文中突出地描述了EGF对实验动物上消化道黏膜的保护和对消化性溃疡的治疗作用。人源性EGF的运用已进入临床，预示着EGF将会在消化道溃疡的治疗中发挥重要作用。     

根除幽门螺杆菌对部队官兵消化性溃疡复发的影响

目的探讨根除幽门螺杆菌(HP)对部队官兵消化性溃疡(PU)复发的影响,寻找降低部队官兵消化性溃疡复发的方法。方法 489例HP阳性消化性溃疡官兵,经正规抗HP治疗后(奥美拉唑胶囊、阿莫西林胶囊、克拉霉素片),根据HP阳性分为HP根除组和HP未根除组,随访1年,比较两组在溃疡复发率、消化道出血复发率的差异。结果 HP根除率为71.2%、溃疡愈合率为92.2%,HP根除组溃疡复发率、消化道出血复发率均明显低于HP未根除组(P<0.01,P<0.05)。结论根除HP可明显降低部队PU患者的复发率。     

The UGI series in renal transplant candidates

We reviewed the charts of 115 renal transplant recipients who had pre-transplant upper gastrointestinal (UGI) barium examinations to assess this examination as a predictor of post-transplant ulceration and hemorrhage. In the past surgical therapy for peptic ulcers was recommended before transplantation because of the risk of life-threatening hemorrhage after transplantation. Peptic ulcer disease was found in 22 patients. Fifteen of these were treated with histamine H2-receptor antagonists and none had ulceration post-transplantation. Three of the seven not so treated had recurrent peptic ulceration. The other 93 examinations were normal. Twelve of the patients with normal examinations developed post-transplant peptic ulceration. We conclude that: (a) the pre-transplant UGI series may not distinguish those patients at risk of UGI ulceration post-transplantation and (b) treatment with H2-receptor antagonists obviates the need for surgical therapy of peptic ulcer disease in these patients before transplantation.     

Roentgen diagnosis of linear ulcers.

Linear peptic ulcerations are not uncommon lesions of the stomach and duodenum and can be demonstrated by upper gastrointestinal series. This is facilitated by the double contrast technique, but they may also be appreciated via compression methods. The criteria found helpful to establish the presence of a linear ulcer include: (a) contour deformity; (b) niche projection; (c) fuzzy line; and (d) folds radiating to a line (crater). Routine use of these criteria with the double-contrast method enabled the authors to diagnose 42 linear ulcers.