超声和钡剂造影在内镜下幽门括约肌切开术治疗先天性肥厚性幽门狭窄中的应用  

Application of Ultrasound and Barium in Endoscopic Sphincterotomy in Treatment of Congenital Hypertrophic Pyloric Stenosis

作　　者：马晓梅[1] 柳建华[2] 王岩[1] 马穗红[2] 曾功君[2] 区文财[2] 罗环千[2] 寇燕妮[1] 许安丽[1] 

机构地区：[1]广东省深圳市宝安区西乡人民医院超声科,518102 [2]广州市第一人民医院功能检查科

出　　处：《中国全科医学》2010年第11期1224-1226,共3页Chinese General Practice

摘　　要：目的探讨超声及钡剂造影在内镜下幽门括约肌切开术治疗先天性肥厚性幽门狭窄(CHPS)中的应用价值。方法行胃镜下幽门括约肌切开术的CHPS患儿20例,应用二维超声诊断CHPS,并测量手术前后幽门管的长径、外径、管壁厚度、肌层厚度、黏膜及黏膜下层厚度;同时根据超声所测幽门管肌层及黏膜层厚度指导手术时电凝刀切开幽门管壁的厚度;利用钡剂造影诊断CHPS并对比手术前后的造影结果。结果超声检查显示术后幽门管的长度、外径、肌层厚度均较术前减少,幽门舒张时可见幽门管腔不同程度地开放,液体顺利通过管腔,管腔随着幽门的舒张、收缩有规律地开放、闭合。术后钡剂造影显示钡剂顺利通过幽门管。结论超声与钡剂造影均是诊断CHPS的可靠方法,超声检查对内镜下幽门括约肌切开术的指导价值更大。Objective To explore the application of 2 -dimensional ultrasound and barium in endoscopic sphincterotomy in treatment of congenital hypertrophic pyloric stenosis （CHIOS）. Methods Two - dimensional ultrasound was used to diagnose CHPS in 20 children undergoing endoscopic sphineterotomy, and the pyloric long diameter, diameter, wall thickness, muscle thickness, mucosa and submueosa thickness were measured before and after operations. According to the ultrasonic - measured pylorie muscle and mucosa thickness, electrocoagulation knife was guided to cut pyloric wall thickness. Barium contrast was used to diagnose CHPS and the imaging results were compared between pre - and post - operations. Results Ultrasound examinations showed that the length of postoperative pyloric, diameter, muscle thickness reduced as compared with preoperative. Different open levels of pyloric lumen were seen when pyloric relaxed, and liquid passed smoothly the lumen. The lumen opened or closed regularly with the pyloric relaxation or contraction. Postoperative barium angiography showed that the barium passed the pyloric lumen. Conclusion Two - dimensional ultrasound and barium angiography, both reliable for CHPS diagnosis, but two -dimensional ultrasound is more valuable in endoscopic sphincterotomy.

关 键 词：幽门狭窄 肥厚性 括约肌切开术 内窥镜 超声检查 钡餐 

分 类 号：R656.6[医药卫生—外科学]