上消化道术后功能异常的X线检查及诊断(附80例报告)

X-ray diagnosis of postoperative functional abnormality of upper alimentary tract (report of 80 cases)

目的 :探讨上消化道术后功能异常的原因、临床表现及影像学特点。方法 :对 80例临床怀疑上消化道术后功能异常的检查结果进行回顾性分析 ,X线检查以简化气钡双重造影为主 ,所有病例均经内窥镜或其它检查确认并追踪观察 3个月以上。结果 :除手术引起的胃肠结构改变外 ,胃肠钡餐还显示 :①胃肠张力降低、形态失常 ;②胃肠动力减弱 ,运动不协调 ;③中等量胃潴留 ,但液体排空正常 ;④胃肠位置呈中线性变化但无出口狭窄梗阻。结论 :功能异常是上消化道术后的常见病症 ,主要原因是迷走神经或交感神经径路损伤 ,X线检查以动力、张力、分泌及排空异常为特点 ,可籍此与器质性病变相鉴别 。

Objective:To investigate the cause, clinical findings,X ray feature and differential diagnosis of postoperative functional abnormality of upper alimentary tract. Methods:80 cases with postoperative alimentary functional changes were examined with simplified double contrast radiography of upper GI tract.All cases were confirmed by endoscopies and other related examinations and followed up for more than 3 months.Results:Besides the structural changes caused by operation,barium meal revealed:①decreased gastrointestinal tonicity and abnormal configuration.②hypokinesis and incoordination of stomach.③moderate gastric retention but with normal emptying of liquid.④no gastric stenosis or obstruction.Conclusions:The main cause of postoperative functional abnormality in alimentary tract is the injury of vagus or sympathetic nerve. Upper GI series can reveal its X ray feature and differentiate it from organic lesions of gastro intestinal tract.