口服甘露醇结合多层螺旋CT小肠造影的应用价值分析

Practical value of oral mannitol combined with multi-slice spiral CT enterography

目的分析口服甘露醇结合多层螺旋CT小肠造影的应用价值。方法35例有小肠症候群进行多层螺旋CT小肠造影的患者,使用随机数字法分为观察组(18例)和对照组(17例)。检查前90 min,观察组患者口服500 ml 20%等渗甘露醇+1000 ml清水,对照组患者口服1500 ml清水。比较两组患者的耐受度及肠管充盈度,动脉期和门脉期不同部位小肠肠壁CT值,动脉期管壁、门脉期管壁、门脉期管腔CT值。结果两组患者的视觉模拟评分法(VAS)评分比较,差异无统计学意义(P>0.05);观察组患者的肠管充盈度评分(3.41±0.68)分明显高于对照组的(2.52±0.50)分,差异具有统计学意义(P<0.05)。两组患者动脉期和门脉期十二指肠、空肠、回肠的肠壁CT值比较,差异无统计学意义(P>0.05)。动脉期和门脉期十二指肠、空肠的肠壁CT值均高于回肠,差异具有统计学意义(P<0.05);十二指肠和空肠的肠壁CT值比较,差异无统计学意义(P>0.05)。两组患者的动脉期管壁、门脉期管壁CT值比较,差异无统计学意义(P>0.05);观察组患者的门脉期管腔CT值(10.49±1.06)Hu高于对照组的(9.55±0.55)Hu,差异具有统计学意义(P<0.05)。两组患者的门脉期管壁CT值均明显高于本组门脉期管腔CT值,差异具有统计学意义(P<0.05)。结论口服甘露醇结合多层螺旋CT小肠造影与既往口服清水相比,前者能够明显改善肠管充盈度,增强门脉期管腔CT值,同时患者具有较好的耐受度。

Objective To analyze the practical value of oral mannitol combined with multi-slice spiral CT enterography.Methods A total of 35 patients with small bowel syndrome undergoing multi-slice spiral CT enterography were divided into observation group(18 cases)and control group(17 cases)using random number method.90 min before the examination,patients in the observation group took 500 ml 20%isotonic mannitol+1000 ml water,and patients in the control group took 1500 ml water.The tolerance and intestinal filling,CT value of intestinal wall in different parts of small intestine in arterial and portal phase,and CT value of the vessel wall in the arterial phase,the vessel wall in the portal phase,and the lumen in the portal phase were compared between the two groups.Results There was no statistically significant difference in visual analogue scale(VAS)score between the two groups(P>0.05);The bowel filling score(3.41±0.68)points of the observation group was obviously higher than(2.52±0.50)points of the control group,and the difference was statistically significant(P<0.05).There was no statistically significant difference in CT value of intestinal wall of duodenum,jejunum and ileum in arterial and portal phase between the two groups(P>0.05).The CT value of intestinal wall of duodenum and jejunum in arterial and portal phase were higher than those of ileum,and the difference was statistically significant(P<0.05).There was no statistically significant difference in CT value of intestinal wall of duodenum and jejunum(P>0.05).There was no statistically significant difference in CT value of vessel wall in arterial and portal phase(P>0.05).The CT value of lumen in portal vein(10.49±1.06)Hu of the observation group was higher than(9.55±0.55)Hu of the control group,and the difference was statistically significant(P<0.05).The CT values of lumen in portal phase of the two groups were significantly higher than those in the arterial phase,and the difference was statistically significant(P<0.05).Conclusion Combination of oral mannitol and multi-slice spiral CT enterography can significantly improve intestinal filling,enhance the CT value of lumen in portal phase,and the patients have good tolerance.