小肠钡剂灌肠检查时插管深度之探讨  

Study of Depth of Intubation in Enteroclysis

作　　者：顾海燕[1] 朱孝廷[1] 邱红星[2] 沈谋绩[1] 

机构地区：[1]上海第二医科大学附属仁济医院放射科,200001 [2]福建邵武市立医院放射科,354000

出　　处：《胃肠病学》1996年第2期119-120,129,共3页Chinese Journal of Gastroenterology

摘　　要：目的:探讨小肠钡剂灌肠检查中插管的深度,以避免不必要的漏诊。材料和方法:回顾性分析1985年至1995年经手术及病理证实术前第一次小肠钡剂灌肠检查中因插管超越病变区而致漏诊的5例病例。结果:小肠钡剂灌肠检查时若导管头插过屈氏韧带达空肠近端,可避免钡剂返流,若钡剂返流入胃囊内不仅会引起呕吐,而且充钡胃囊易与十二指肠及空肠近端重叠而掩盖病变,常可导致导管头近端病变的漏诊:若导管头未插过屈氏韧带,则回肠充钡不足,不易很好显示回肠病变,尤其是麦克耳憩室的显示。结论:作小肠钡剂灌肠检查前,应有一张良好的显示胃及十二指肠框部的双重对比相X线片,而作小肠钡剂灌肠检查时,导管头的位置则以插过屈氏韧带为宜。Background/Aims: To study the deptn of intubation in enteroclysis to avoid misaiagnosis. Methods: Five surgery-proved cases were reviewed from 1985 to 1995. These cases were all misdiagnoscd in the first enteroclysis, bacause the tip of tube was intubated too deep to discover the region of disorder. Results: In enteroclysis, if the tip of tube passes through the Treitz's ligament and reaches the proximal jejunum, reflux of barium does not occur and the shadows caused by barium in stomach overlapping that caused by barium in duodenum or proximal jejunum will both be avoided. It usually causes misdiagnosis of the diseases located in proximal portion of tube. Meanwhile if the tip of tube doesn't pass throuth the Treitz's ligament, the diseases of ileum, especially Meckel's diverticulum can not be easily shown. Conclusion:' There should be a good GI double contrast films which clearly shows the stomach and duodenal loop before enteroclysis. And in enteroclysis the suitable position of the tip is just passing through the Treitz's ligament.

关 键 词：小肠灌肠 插管 X线造影术 

分 类 号：R574[医药卫生—消化系统]