胃肠超声技术对胃食管反流病的辅助诊断效能

The auxiliary diagnostic efficacy of gastrointestinal ultrasound in gastroesophageal reflux disease

目的 探讨胃肠超声在胃食管反流病患者中的辅助诊断效能。方法 选择2020年1月至2022年7月疑似胃食管反流病患者178例,所有患者均行胃肠超声检查,并以电子胃镜检查结果为“金标准”,分析胃肠超声在胃食管反流病中的诊断效能。对胃肠超声检查阳性患者以随机数字表法分为2组。对照组使用奥美拉唑治疗,观察组使用清热和胃法治疗,2组均完成4周治疗,比较2组证候积分及胃肠激素水平。结果 178例疑似胃食管反流病患者经“金标准”检查确诊94例,确诊率52.81%。胃肠超声检查阳性88例,检查准确度为91.01%(162/178)、诊断灵敏度为88.30%(83/94)、特异度94.05%(79/84);由2位医师对胃肠超声诊断胃食管反流病进行诊断,一致性分析Kappa值为0.620,P=0.000,Kappa值0.4~0.75,说明胃肠超声诊断结果与金标准结果存在中度一致性。观察组治疗4周后反流、烧心、嗳气、胃脘闷胀、两胁胀满评分低于对照组(P<0.05);观察组治疗4周后胃泌素、胃动素水平高于对照组(P<0.05),血管活性肠肽低于对照组(P<0.05)。结论 胃肠超声技术对胃食管反流病患者具有较高的诊断效能,诊断灵敏度及特异度较高;对已确诊患者,给予清热和胃法干预能降低证候积分,改善患者胃肠激素水平。

Objective To investigate the auxiliary diagnostic efficacy of gastrointestinal ultrasound on gastroesophageal reflux disease.Methods A total of 178 patients suspected of gastroesophageal reflux disease from January 2020 to July 2022 were selected as subjects.All patients were examined by gastrointestinal ultrasonography.The diagnostic efficacy of gastrointestinal ultrasonography on gastroesophageal reflux disease was analyzed based on the results of electronic gastroscopy as the gold standard.Patients with positive gastrointestinal ultrasound examination were randomly divided into two groups.The control group was treated with omeprazole,and the observation group was treated with clearing heat and harmonizing stomach method.Four weeks of treatment was performed,and the syndrome score and gastrointestinal hormone level of the two groups were compared.Results Among 178 suspected patients with gastroesophageal reflux disease,94 were confirmed through the"gold standard"examination,with a diagnostic rate of 52.81%.Totally 88 cases were positive for gastrointestinal ultrasound examination,with an accuracy of 91.01%(162/178),diagnostic sensitivity of 88.30%(83/94),and specificity of 94.05%(79/84).Two physicians reviewed the gastrointestinal ultrasound scans to diagnose gastroesophageal reflux disease.The consistency analysis showed that the Kappa value was 0.620(P=0.000),and a Kappa ranging from 0.4 to 0.75 indicated a moderate consistency between the diagnostic results of gastrointestinal ultrasound and the gold standard results.After 4 weeks of treatment,the scores of reflux,heartburn,belching,abdominal distension,and bilateral rib fullness in the observation group were significantly lower than those of the control group(P<0.05).After 4 weeks of treatment,the levels of gastrin and motilin in the observation group were significantly higher than those in the control group(P<0.05).The vasoactive intestinal peptide was significantly lower than that of the control group(P<0.05).Conclusion Gastrointestinal ultrasound has a high diagnostic efficacy on gastroesophageal reflux disease,with high diagnostic sensitivity and specificity.For those with the confirmed gastroesophageal reflux disease,clearing heat and harmonizing stomach method can reduce syndrome scores and improve gastrointestinal hormone levels.