CAJ | 학술논문

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.
목적 탐토초성급패제조영재내경하유문괄약기절개술치료선천성비후성유문협착(CHPS)중적응용개치.방법 행위경하유문괄약기절개술적CHPS환인20례,응용이유초성진단CHPS,병측량수술전후유문관적장경、외경、관벽후도、기층후도、점막급점막하층후도;동시근거초성소측유문관기층급점막층후도지도수술시전응도절개유문관벽적후도;이용패제조영진단CHPS병대비수술전후적조영결과.결과 초성검사현시술후유문관적장도、외경、기층후도균교술전감소,유문서장시가견유문관강불동정도지개방,액체순리통과관강,관강수착유문적서장、수축유규률지개방、폐합.술후패제조영현시패제순리통과유문관.결론 초성여패제조영균시진단CHPS적가고방법,초성검사대내경하유문괄약기절개술적지도개치경대.
Objective To explore the application of 2-dimensional ultrasound and barium in endoscopic sphincterotomy in treatment of congenital hypertrophic pyloric stenosis (CHPS).Methods Two-dimensional ultrasound was used to diagnose CHPS in 20 children undergoing endoscopic sphincterotomy,and the pyloric long diameter,diameter,wall thickness,muscle thickness,mucosa and submucosa thickness were measured before and after operations.According to the ultrasonic-measured pyloric 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 pre-operative.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.