胸部CT三维重建与食管吞钡在食管异物诊治中的差异

Comparative analysis chest CT 3D reconstruction and esophagus barium swallow in esophagus foreign body

目的:比较胸部CT三维重建与食管吞钡在食管异物诊治中的作用,为食管异物的诊治提供参考。方法:回顾性分析136例食管异物患者的资料,其中采用食管吞钡97例,采用胸部CT三维重建17例,采用两种影像学检查15例,比较其在食管异物诊断中的差异及对临床诊治的影响。结果:食管吞钡与胸部CT三维重建阳性患者,术中发现食管异物的比例分别为91.8%(89/97)和88.2%(15/17)。初诊采用胸部CT三维重建患者一次手术取出异物的成功率为100%,高于初诊采用食管吞钡患者(成功率为91.0%)。结论:胸部CT三维重建和食管吞钡对食管异物均具有较高的诊断率,胸部CT三维重建在如下情况较食管吞钡有明显优势:①食管中下段异物,尤其伴食管穿孔者;②出现发热,血象高,怀疑存在食管周围脓肿者;③出现呼吸困难者;④异物残留时间较长,超过5d者;⑤6岁以内的儿童食管残留不透光异物。

Objective：To compare the diagnosis and therapeutic between chest computed tomography three-dimen-sional reconstruction and esophagus barium swallow in esophagus foreign body. Method：retrospective analyze one hundred and thirty six patients who suffered from esophagus foreign body in our hospital,97 cases using esophagus barium swallow,17 cases using chest computed tomography three-dimensional reconstruction,15 cases using both. Result：The pa-tients who showed positive of esophagus foreign body in esophagus barium swallow or chest computed tomography three-di-mensional reconstruction,91. 8% （ 89 /97） cases or 88. 2% （ 15 /17） cases found esophagus foreign bodies finally. All cases successfully took out the esophagus foreign bodies only through one operation which used chest computed tomography three-dimensional reconstruction as primary examination,while only 91. 0% for those used esophagus barium swallow as primary examination. Conclusion：Both chest computed tomography three-dimensional reconstruction and esophagus barium swallow showed high diagnostic efficiency on esophagus foreign body. Chest computed tomography three-dimensional reconstruction had advantages in patients with one of following conditions：①esophagus foreign body located in the middle of the esophagus,especially complicated with esophagus perforation; ②with fever,high white blood count,presence of abscess surrounding the esophagus was suspected; ③with dyspnea; ④with a history of esophagus foreign body longer than 5 days; ⑤younger than 6 years old.