非离子型对比剂在婴儿胃肠造影检查中的应用

Clinical application of non-ionic contrast medium in contrast examination of upper gastrointestinal tract in infants

目的探讨碘海醇作为对比剂的消化道造影在婴儿上消化道疾病检查中的应用价值。方法选择临床怀疑消化道疾病的68例患儿,其中男性43例,女性25例,年龄1天~1岁。新生儿42例,婴儿26例。采用口服或胃管推注0.9%氯化钠溶液稀释后的碘海醇,行上消化道数字胃肠造影检查。结果 42例新生儿中,食管闭锁6例,先天性幽门肥厚6例,十二指肠梗阻11例,空肠梗阻2例;上述25例全部行手术治疗;贲门松弛10例,特发性胃扭转7例,此17例行保守治疗。26例婴儿中,胃重复畸形1例,十二指肠梗阻4例,此5例行手术治疗;食管裂孔疝3例,贲门松弛3例,特发性胃扭转5例,消化道造影无明确病变10例,此21例行保守治疗。结论碘海醇用于婴儿胃肠造影检查,能得到清晰的图像,同时弥补了钡餐检查在婴儿应用的缺点,拓宽了小儿消化道检查范围,是一种安全性更高的检查方法。

Objective To evaluate the efficiency of iohexol in upper digestive tract contrast examination for diagnosing disease of digestive tract in infants. Methods A total of 68 cases（42 newborns and 26 infants） with suspected upper digestive tract disease were enrolled, which included 43 males and 25 females, aged 1 day- 1 year old. The iohexol diluted with 0.9 % sodium chloride solution was administrated orally or through gastric canal for upper digestive tract contrast. Results Among 42 newborns, there were 6 cases with esophageal atresia, 6 cases with congenital hypertrophic pyloric stenosis; 11 cases with duodenal ileus and 2 cases with jejunal ileus, all of which received operation treatment. The other 10 cases with cardia chalasia and 7 cases with volvulus of stomach received conservative treatment. Among 26 infants, 1 case with duplication of stomach and 4 cases with duodenal ileus received operation treatment; The other 21 cases included 3 cases with esophageal hiatal hernia, 3 cases with cardia chalasia, 5 cases with vulvulus of stomach and 10 cases with non-abnormalities received conservative treatment. Conclusion It is demonstrated that iohexol contrast examination retrieves the insufficient of barium meal examination for digestive tract in infants. It ＇s a safe and reliable method in diagnosis of congenital digestive tract malformation in newborns.