农村无症状人群口服超声造影筛查胃十二指肠疾病的临床应用价值

Clinical application value of oral contrast-enhanced ultrasound in screening of gastric and duodenal diseases in rural areas

目的探讨口服超声造影(OCUS)筛查农村无症状人群胃十二指肠病变的临床价值。方法选取上海市崇明县农村地区5个自然村无症状人群计3240例,开展OCUS筛查胃十二指肠疾病。让受检者口服超声造影剂,实时测量贲门内径、胃体部胃壁厚度、幽门管内径等,观察各部位形态、层次结构及其动态改变。凡检出声像图异常改变者行胃镜检查。采用Kappa检验分析OCUS筛查结果与病理结果的一致性。结果 OCUS筛查检出各类胃十二指肠病变共51例,检出率为1.57%(51/3240),筛查结果与胃镜和(或)手术病理检查符合率为93.75%(45/48),一致性好(Kappa=0.905)。共检出胃癌5例,检出率为0.15%(5/3240)。结论 OCUS可用于农村地区胃十二指肠疾病筛查,值得进一步研究评估。

ObjectiveTo discuss the value of oral contrast ultrasonography （OCUS） in the screening of gastric and duodenal disease in asymptomatic people in rural communities. MethodsAn OCUS screening was conducted in 3240 residents of Chongming County in Shanghai. After taking oral ultrasonic contrast agent, real-time observation of cardia, gastric fundus, gastric body and gastric angle, gastric antrum and duodenal bulb was conducted for each subject to detect the cardiac diameter, the body of the stomach wall thickness, pyloric canal diameter and each part of the form and structure. All subjects with abnormal sonogram were examined by gastroscopy. Kappa test was used to analyze the consistency between OCUS screening results and pathological results. ResultsOCUS screening detected a total of 51 cases of various types of gastric and duodenal lesions, the total detection rate was 1.57%. The coincidence rate between screening results and gastroscopy/pathology examination was 93.75% （45/48） with a good consistency （Kappa=0.905）. Five cases of gastric cancer with the detection rate of 0.15% （5/3240） were found. ConclusionOCUS can be used for the screening of gastric and duodenal diseases in the rural community, and it is worth further research and evaluation.