X线钡餐与电子胃镜检查诊断胃溃疡的应用比较

Comparison of barium X-rays and electronic gastroscopy in the diagnosis of gastric ulcer

目的考察和对比X线钡餐造影与电子胃镜检查诊断胃溃疡的临床价值。方法按就诊顺序纳入2014年1月-2016年12月经X线钡餐造影和电子胃镜2种检查的胃溃疡确诊患者共100例进行临床资料的回顾性分析。以最终临床诊断结果为标准,考察这2种检查手段诊断胃溃疡的诊断结果,总结其各自的影像学特点。结果X线钡餐造影检查对胃溃疡诊断的符合率为63.00%(63/100),电子胃镜检查为100.00%(100/100);2组对胃溃疡诊断的符合率比较,差异具有统计学意义(χ^2=28.970,P<0.05)。2种检查手段对恶性胃溃疡诊断的符合率均为100.00%(5/5)。X线钡餐造影下胃溃疡特征:80.95%出现龛影征象,9.52%出现细条状充钡龛影,41.27%出现龛影底部"环影"征,15.87%可见"双边征",50.79%出现黏膜纠集征象,6.35%可见透明细线影。电子胃镜下胃溃疡特征:64.00%为溃疡基底部苔厚而污秽,病灶周围黏膜充血、水肿;35.00%为溃疡病灶周围上皮再生形成红晕,皱襞向溃疡集中;11.00%为溃疡基底部苔薄,病灶周围见红晕或皱襞集中现象;5.00%为溃疡基底部溃疡苔消失,中央区域遗留淡红色或白色的平坦凹陷或瘢痕。结论应用电子胃镜检查对胃溃疡诊断的准确率更高,X线钡餐造影检查对胃溃疡诊断的特异性更高,2种检查手段的敏感性相当。X线钡餐造影与电子胃镜检查在诊断胃溃疡方面各有所长,后者诊断的符合率更高,临床工作中应结合每一患者的具体情况取其各自的临床优势。

Objective To investigate and compare the clinical value of barium X-ray and electronic gastroscopy in the diagnosis of gastric ulcer.Methods One hundred patients with gastric ulcer diagnosed by barium X-ray and electronic gastroscopy from January 2014 to December 2016 were enrolled in the retrospective analysis of clinical data.Based on the final clinical diagnosis results of gastric ulcer,the efficacy of these two methods was investigated,and their respective imaging characteristics were summarized.Results The coincidence rate in the diagnosis of gastric ulcer of barium X-ray examination was 63.00%(63/100),and 100.00%(100/100)of Electronic gastroscopy,There was significant difference in the coincidence rate between the two groups in the diagnosis of gastric ulcer(χ^2=28.970,P<0.05).The coincidence rate of the two methods in the diagnosis of malignant gastric ulcer was 100.00%(5/5).The characteristics of gastric ulcer showed by barium X-ray examination:80.95%had niches,9.52%had thin barium-filled niches,41.27%had"ring"signs at the bottom of niches,15.87%had bilateral signs,50.79%had mucosal convergence signs,and 6.35%had transparent thin lines.The characteristics of gastric ulcer by electronic gastroscopy:64.00%of ulcer basal coating was thick and dirty,mucosal congestion and edema around the lesion;35.00%of ulcer lesion epithelial regeneration formed red halo,folds concentrated to ulcer;11.00%of ulcer basal coating was thin,red halo or folds concentrated around the lesion;5.00%of ulcer basal coating disappeared,leaving a pink or white flat depression/scar in the central area.Conclusion Electronic gastroscopy,compared with barium X-ray,is more accurate in the diagnosis of gastric ulcer;however,barium X-ray is more specific.The sensitivity of the two methods is similar.The barium X-ray and electronic gastroscopy have their own advantages in the diagnosis of gastric ulcer,the latter is more accurate.In clinical work,each patient’s specific conditions should be combined with their respective clinical advantages.