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[目的]总结先天性肥厚性幽门狭窄的X线特征,探讨X线检查诊断先天性肥厚性幽门狭窄的临床价值。[方法]回顾性分析经手术证实的35例先天性肥厚性幽门狭窄患者的X线检查结果,并计算X检查结果的诊断敏感度。[结果]①35例先天性肥厚性幽门狭窄患者,X线检查发现有胃排空延迟35例(100.0%),胃扩张31例(88.6%),胃食管反流26例(74.3%);“鸟嘴征”30例(85.7%),“线样征”29例(82.9%),“肩样征”25例(71.4%),“双轨征”22例(62.9%),“蕈伞征”20例(57.1%)。②上述5项征象,以任意2项阳性即诊断先天性肥厚性幽门狭窄,X线钡餐的诊断敏感度为100.0%;以任意3项阳性作为诊断标准,诊断敏感度为88.6%;以任意4项阳性作为诊断标准,诊断敏感度为65.7%;以5项同时阳性为诊断标准,X线钡餐的诊断敏感度为31.4%。[结论]先天性肥厚性幽门狭窄的典型X征象包括狭窄、细长的幽门管以及肥厚压迫的幽门环肌。使用任意3项阳性作为先天性肥厚性幽门狭窄的诊断标准较好,可以得到较好的诊断敏感度和特异度。
[Objective] To summarize the X-ray features of congenital hypertrophic pyloric stenosis and explore the clinical value of X-ray examination in diagnosing congenital hypertrophic pyloric stenosis. [Methods] The results of X-ray examination of 35 patients with congenital hypertrophic pyloric stenosis confirmed by surgery were retrospectively analyzed and the diagnostic sensitivity of X-ray examination results were calculated. [Results] Thirty-five patients with congenital hypertrophic pyloric stenosis were delayed in gastric emptying in 35 cases (100.0%), gastric dilatation in 31 cases (88.6%) and gastroesophageal reflux in 26 patients (74.3%). There were 30 cases (85.7%) with “beak sign”, 29 cases (82.9%) with line sign, 25 cases with shoulder sign (71.4%) and 22 cases with double track sign 62.9%), and 20 cases (57.1%) of “mushrooms sign”. ② The above five signs, with any two positive diagnosis of congenital hypertrophic pyloric stenosis, the diagnostic sensitivity of X-ray barium meal was 100.0%; to any 3 positive as the diagnostic criteria, the diagnostic sensitivity was 88.6%; with any 4 The positive rate of diagnosis was 65.7%. The diagnostic sensitivity of X-ray barium meal was 31.4% with 5 simultaneous positive as the diagnostic criteria. [Conclusions] The typical X signs of congenital hypertrophic pyloric stenosis include stenosis, slender pyloric duct, and hypertrophic oppressed pyloric ring muscle. The use of any 3 positive as congenital hypertrophic pyloric stenosis diagnostic criteria better, you can get a better diagnostic sensitivity and specificity.