贲门失弛缓症的经腹超声诊断  

Transabdominal ultrasonography in the diagnosis of achalasia

作　　者：章建全[1] 陈晓华[2] 

机构地区：[1]第二军医大学长征医院超声科,上海200003 [2]浙江省衢州市人民医院超声科

出　　处：《第二军医大学学报》2001年第4期310-312,共3页Academic Journal of Second Military Medical University

摘　　要：目的 :探讨经腹超声诊断贲门失弛缓症的临床应用价值。 方法 :选择 8名贲门失弛缓症患者 ,设立 10名正常人和 8名贲门癌患者作对照 ,对 3组受试者进行经腹超声饮水试验 ,比较三者的超声表现 ;并对贲门失弛缓症患者经药物治疗、球囊扩张或肉毒杆菌毒素注射前后的超声表现进行比较。 结果 :(1)正常人饮水试验前食管腔及贲门口闭合 ,饮水时贲门迅速开放 ,水流快速通过。 (2 )贲门失弛缓症患者饮水试验前食管下段已经扩张 ;饮水时连续观察 10 min,贲门始终不弛张、水流不能通过者 5例 ,贲门间断性张开、水流间断通过者 3例 ;饮水试验后 30 min再检查时见全部患者的食管中仍滞留有水。 (3)贲门癌患者饮水前表现为贲门环增大、贲门壁增厚 ,食管未扩张 ;饮水时水流通过贲门较缓慢。 结论 :经腹超声检查因只需饮少量水而易为患者接受 ;而且它通过显示贲门环的大小、贲门壁厚度以及饮水时水流通过贲门的状态 ,而达到迅捷、可靠地诊断贲门失弛缓症 ,故也是合适的治疗评价手段。Objective: To assess the clinical application of transabdominal ultrasonography for the diagnosis of achalasia. Methods: The subjects were divided into 3 groups, with 8 patients suffered from achalasia as patient group, 10 normal individuals and 8 patients with cardiac carcinoma as controls. All subjects received water provocative test to study the lower esophagus and cardia. Sonographic findings were compared between the 3 groups. After treatment by administration of drugs, pneumatic balloon dilation, or intrasphincteric injection of botulinum toxin, the 8 patients were re examined by TAUS for longitudinal comparison. Results: (1)The normal subjects had no dilation of cardia and lower esophagus before drinking water, but their cardias opened rapidly with the drinking action. (2)All the patients of achalasia were found to have dilation of lower esophagus before taking water. During 10 min continuous TAUS scanning, 5 of 8 demonstrated absence of relaxation of cardias and absence of water from the esophagus into the stomach. The other 3 showed slight and intermittent relaxation of cardias with water flow into the stomach. Thirty minutes after water provocative test, all the 8 patients had water retardation within the lower esophagus. (3)The patients of cardiac carcinoma had an ultrasound feature of cardiac ring enlargement and thickening of cardiac wall without dilation of lower esophagus before water provocative test. Water passed the cardia more slowly. Conclusion: TAUS is a readily accepted examination. It can quickly give reliable diagnostic clues to achalasia. TAUS can also be used for making assessment of therapeutic effect on achalasia. [

关 键 词：贲门失弛缓症 饮水试验 超声波检查 经腹超声波诊断 

分 类 号：R573.7[医药卫生—消化系统]