口服胃肠超声造影评价尿毒症患者胃肠动力及胃壁形态改变

Gastroduodenal Motility and Morphological Changes in Patients with Uremia by Gastrointestinal Ultrasonography Using Oral Contrast Agents

目的应用口服胃肠超声造影结合灰阶超声及彩色多普勒超声评估尿毒症患者胃十二指肠动力及胃壁形态的改变。资料与方法35例经临床诊断为尿毒症但未接受透析治疗的患者作为尿毒症组,同时选取31名健康志愿者作为对照组,通过口服胃肠超声造影结合灰阶超声及彩色多普勒超声检测各项胃肠动力学的超声评估参数及胃壁形态。结果尿毒症组胃窦收缩频率、胃窦动力指数(MI)及胃排空率(GER)低于对照组(P<0.05),胃排空时间(ET)较对照组长(P<0.05),十二指肠胃窦反流(DGR)率高于对照组(P<0.05);尿毒症组胃窦胃壁厚度大于对照组(P<0.05),其中19例胃壁层次模糊,其胃壁层次清晰性显著低于对照组(P<0.05);餐后20minMI与ET呈负相关(r=-0.061,P<0.05),GER与年龄、ET均无相关性(P>0.05)。结论口服造影超声检查是一项简便、非侵入性、可重复进行的实时评估尿毒症患者胃动力改变及胃壁形态改变的方法,并可同时检测十二指肠胃窦反流的发生。

Purpose To evaluate the gastroduodenal motility and morphological changes of gastric wall in patients with uremia by grey scale gastrointestinal ultrasonography and color Doppler ultrasound using oral contrast agents.Materials and Methods Thirty-five patients clinically diagnosed as uremia without history of dialysis treatment,were enrolled as the uremia group.Thirty-one healthy volunteers were enrolled as the control group in this study.The two groups underwent grey scale gastrointestinal ultrasonography and color Doppler ultrasound using oral contrast agents and the ultrasonographic parameters of gastroduodenal dynamic function and gastric wall morphology were obtained.Results The frequency of antral contractions,the motility index and the gastric emptying rate in the uremia group were lower than those in the control group（P 0.05）.The gastric emptying time in the uremia group was longer than that in the control group（P 0.05）.The rate of duodeno-gastric reflux in the uremia group was higher than that in the control group（P 0.05）.The gastric walls in the patients of the uremia group appeared thicker and more obscure than the normal control.Conclusion Gastrointestinal ultrasonography using oral contrast agents is a simple,noninvasive imaging method,which can be used repeatedly to make a real-time assessment on the gastric dynamic changes and morphological changes of gastric wall in patients with uremia,and can detect the duodenogastric reflux as well.