高频超声在胃镜下幽门肌切开术治疗CHPS的应用价值

目的　旨在通过运用高频超声观察行胃镜下幽门环肌切开术治疗先天性肥厚性幽门狭窄(CHPS)前后肥厚狭窄的幽门管组织各层粘膜改变以及胃内液体通过幽门管情况,以探讨高频超声在此新型微创术式的应用价值和临床意义。方法　对65例CHPS的患儿进行超声检查,观察CHPS患儿术前与术后1天、术后1周、术后1个月、术后6个月幽门管各粘膜层厚度的改变以及幽门管内径变化。结果　手术后1天黏膜及黏膜下层厚度较手术前增加；术后1周及术后1个月幽门管长径、直径、幽门肌层厚度较手术前减小,黏膜及黏膜下层厚度无变化；手术后6个月幽门管长径、直径、幽门肌层厚度、黏膜及黏膜下层厚度均较手术前减少。术后胃内液体通过幽门管的次数较术前明显增多,幽门管开放程度增大。结论　根据高频超声所测得的胃镜下幽门肌切开术治疗CHPS前后的数据发现,幽门肌层和黏膜及黏膜下层厚度的变薄以及幽门管的狭窄程度改善,得出该微创术式是有效的手术方法,超声对其手术的疗效评估有重要的意义。

Value of High Frequency Ultrasound in the Treatment of CHPS by Endoscopic Sphincterotomy

Objective Hope that through the use of high frequency ultrasound to observe before and after endoscopic pyloromyotomy for congenital hypertrophic pyloric stenosis (CHPS) the gastric mucosa layers of pyloric canal stenosis tissue change and liquid through the pyloric canal, to discuss the clinical significance and application value of high frequency ultrasound in this new type of minimally invasive surgery. Methods 65 children with CHPS were examined by ultrasonography. The changes of the thickness of the mucosa of the pyloric tube and the diameter of the inner diameter of the pyloric tube were observed before the operation and 1 days, 1 weeks, 1 months and 6 months after the operation. Results 1 days after surgery mucosa and submucosa thickness increased as compared with that before operation; 1 weeks and 1 months after surgery the pyloric tube length , diameter, thickness of pyloric muscle decreased as compared with that before operation, no change in mucosa and submucosa thickness; 6 months after surgery, the pyloric tube length, diameter, thickness of pyloric muscle, mucosa and submucosa thickness compared with surgery decreased. The number of gastric fluid passing through the pyloric canal increased significantly after operation, and the extent of pyloric canal opening increased. Conclusion Data obtained from high frequency ultrasound before and after endoscopic pyloromyotomy for the treatment of CHPS were found, pyloric muscular layer and mucosa and submucosa thickness and pyloric stenosis improved, the minimally invasive surgical method is effective, ultrasound has important significance in evaluating the curative effect of the operation.