摘要
目的:介绍一种新的X线钡剂改良法,探讨其在复杂食管异物中的应用价值。材料与方法:34例经内镜证实的复杂食管异物,行X线钡剂改良法检查,即第一口用钡剂、用量要少,分析影像特征,记录检查过程中的并发症。结果:34例复杂食管异物中,体形较大异物4例(土豆块1例、肉骨头1例、肉块2例),其X线表现为管腔内不规则充盈缺损及杯口状阻塞。锐利异物7例(鸡骨3例、粗鱼刺4例),均滞留于食管狭窄处,2例异物尖端突出腔壁外,局部蠕动异常。咽功能紊乱5例,其中3例少量钡剂呛入气管。食管损伤13例,食管壁局限性肿胀向腔内突出形成充盈缺损3例;食管前壁弥漫性肿胀2例,管腔明显狭窄;黏膜损伤6例,表现为黏膜增粗、紊乱、模糊;5例食管黏膜下撕剥,表现为黏膜下囊袋状积钡;1例中段食管黏膜广泛剥脱、阻塞管腔,表现为管腔内形态可变的充盈缺损。检查过程中无严重并发症发生。结论:X线钡剂改良法提高了检查安全性,既能达到诊断目的又能减少损伤,值得临床推广应用。
Purpose： To introduce a novel modified X-ray barium method and explore its clinical value in evaluation of complicated esophageal foreign bodies. Materials and Methods： A modified X-ray barium examination, namely first small oral barium , was applied to 34 cases with complicated esophageal foreign bodies. All cases were proven by esophagoscope ex- amination. Results： Of 34 cases, 4 cases with larger shape（potatoe 1, bone 1, meat pieces 2） , X-ray findings were intracavity filling defects and cup-mouth-shape filling, 7 patients with sharp esophageal foreign bodies（ chicken bone 3, fish bone 4）. lodged in the narrow part of esophageal. 5 cases with esophagotracheal fistula. 13 cases with esophageal injury： 3 cases with esophageal wall localized swelling, manifest as filling defect; 2 cases with esophageal anterior wall extensive swelling, manifest as luminal narrow; 6 cases of mucous membrane interruption , hyperplasia of local esophageal mucosa ; 5 case of mucous membrane discectiom, manifest as black pocket filled with barium. 1 case of extensive intramural rupture of the esophagus. Conclusion： The novel modified X-ray barium can improve the safety in the evaluation of complicated esophageal foreign bodies. It is worthy of clinical application and popularization.
出处
《现代医用影像学》
2013年第1期28-30,共3页
Modern Medical Imageology
关键词
食管异物
食管损伤
放射摄影术
Esophageal foreign body Esophageal injury Radiography
