先天性巨结肠类缘病的X线诊断——与先天性巨结肠对照分析

The X-ray Diagnosis of Hirschsprung Allied Disease:A Comparative Study with Hirschsprung’s Disease

目的探讨先天性巨结肠类缘病的X线表现特征。资料与方法回顾分析经病理证实的14例巨结肠类缘病患者的钡剂灌肠X线表现,并与先天性巨结肠进行对照分析。结果14例X线表现多样。9例直肠、乙状结肠或降结肠有痉挛狭窄,其中2例呈跳跃性狭窄,1例直肠及整个结肠细小,近段结肠有不同程度的扩张;13例未见移行段;24h复查13例结肠内有大量钡剂残留;12例结肠有较多痉挛切迹;3例整个结肠张力高呈"腊肠样",不扩张或稍扩张。巨结肠类缘病的X线征象与巨结肠比较移行段、痉挛段肠管不规则收缩的P值<0.05,24h钡剂残留情况及痉挛狭窄段P值>0.05。结论钡剂灌肠有下列X线征象时应警惕有巨结肠类缘病:(1)痉挛段长且有较多痉挛切迹,痉挛段与扩张段之间没有移行段;(2)结肠张力高,形态僵直如"腊肠样";(3)"跳跃型"和"全结肠型"痉挛狭窄。

Objective To explore X-ray features of the Hirschsprung allied disease. Materials and Methods The barium enema X-ray findings of 14 cases with Hirschsprung allied disease and 47 cases of Hirschsprung＇s disease confirmed by pathology were analyzed retrospectively. Results The barium enema X-ray findings of 14 cases of Hirschsprung allied disease were varied, 9 cases appeared as stenosis in rectum,descending colon and sigmoid colon, obvious expansion of the proximal colon, 13 cases had no transition zone, barium retained at 24 hours in 13 cases, 12 cases had small spasm notch, 3 eases appeared as ＂sausage-like＂ colon with little or no colon expansion. A comparison of the X-ray findings of Hirschsprung＇ s disease with allied disorders showed that there was great difference in transition zone and the irregular contractions （ P 〈 0.05 ）, no difference was found in the narrow zone and the barium retained at 24 hours （ P 〉 0.05 ）. Candusian The following X-ray signs on barium enema should be alert to Hirschsprung allied disease ： （ 1 ） the long narrow zone with- out the transition zone between the narrow zone and the expansion zone, the intestinal spasm notch ; a large amounts of reaidual barium at 24-hour review; （ 2 ） the entire colon appear as ＂sausage-like＂ ; （ 3 ） special type： ＂Jump＂ stenosis or ＂total colon＂ stenosis.