摘要
目的探讨经腹胃充盈超声检查对胃石合并胃溃疡的诊断价值。方法回顾性分析2021年2月—2024年2月于山东第一医科大学第二附属医院进行胃镜检查的疑似胃石合并胃溃疡患者115例,所有患者均进行了胃镜检查与经腹胃充盈超声检查,收集患者胃内异物回声、活动度、大小形态,溃疡面回声、厚度、部位、凹陷直径,胃壁结构层次与周围组织情况等参数。以病理检查作为金标准,分析经腹胃充盈超声结果的准确性,对2种诊断方式测得的溃疡面直径与胃石大小进行相关性分析。结果115例患者进行胃镜检查,其中胃石合并胃溃疡阳性患者107例,阴性患者8例,以此作为金标准,经腹胃充盈超声诊断胃石合并胃溃疡的准确率为97.39%(112/115),灵敏度为99.07%(106/107),特异度为75%(6/8)。Kappa值为0.786,P<0.001。经腹胃充盈超声中胃石直径与溃疡面直径具有正相关关系(r=0.713,P<0.001);胃镜检查下的胃石直径与溃疡面直径具有正相关关系(r=0.722,P<0.001)。经腹胃充盈超声造影图像中胃腔内可见强回声圆形或椭圆形团,溃疡部位胃壁黏膜连续性中断,呈口大底小样凹陷,可见强回声斑,缺损部位直径约为4~17 mm。结论经腹胃充盈超声在诊断胃石合并胃溃疡方面有较高的诊断价值,且具有无交叉感染风险、无创性等特点,可作为胃石合并胃溃疡诊断中的重要检查手段。
Objective:To explore the diagnostic value of gastric bezoars combined with gastric ulcer by gastric stomach filling ultrasound.Methods:We analyed the patients who came to The Second Affiliated Hospital of Shandong First Medical University from February 2021 to February 2024 for gastroscopy testing.115 patients with gastric bezoars combined with gastric ulcer were conducted as research objects to analyze the accuracy of the abdominal stomach filling the ultrasound results,observe and record parameters such as the echo,activity,size form,ulcer surface echo,thickness,part,depression diameter,stomach wall structure level and surrounding tissue conditions.The diameter of the ulcer surface measured by the diagnosis method is analyzed with the size of the gastric bezoars.Results:Pathological biopsy:115 patients conducted gastroscopy testing,among whom 107 are positive and 8 are negative.As a gold standard,the accuracy of gastric bezoars combined with gastric ulcers was 97.39%(112/115).The sensitivity is 99.07%(106/107),and the specificity is 75%(6/8).KAPPA value is 0.786(P<0.001).The diameter of the gastric bezoars in the gastric filling ultrasound has a positive correlation with the diameter of the ulcer surface(r=0.713,P<0.001).The diameter of the gastric bezoars under gastroscopy testing has a positive correlation with the diameter of the ulcer surface,rs is 0.722(P<0.001).Gastric filling ultrasonic images can be seen as a strong round or oval group in the gastric cavity,The continuity of the gastric wall mucosa at the ulcer site is interrupted,presenting as a small concavity of the big mouth and small bottom,with visible strong echo spots.The diameter of the concavity is about 4~17 mm.Conclusion:Stomach filling ultrasound has a very high diagnostic value in diagnosis of gastric bezoars combined with gastric ulcers,with the characteristics of noninvasiveness and non-cross infection,making it a crucial means for the examination of gastric bezoars combined with gastric ulcers.
作者
秦超
张家君
王充强
沈雯怡
王晶
刘燕
QIN Chao;ZHANG Jiajun;WANG Chongqiang;SHEN Wenyi;WANG Jing;LIU Yan(Department of Ultrasound,The Second Affiliated Hospital of Shandong First Medical University,Taian 271000,China)
出处
《山东第一医科大学(山东省医学科学院)学报》
2025年第5期283-286,共4页
Journal of Shandong First Medical University & Shandong Academy of Medical Sciences
基金
泰安市科技创新发展计划(2021NS433)。
关键词
胃石
胃溃疡
胃充盈超声检查
胃镜
gastric bezoars
gastric ulcer
gastric filling ultrasonography
gastroscopy testing
