| 摘要: |
| 目的 探讨多普勒超声技术评估胃镜下幽门肌切开术治疗先天性肥厚性幽门狭窄（CHPS）疗效的临床价值。方法 应用多普勒超声对65例确诊为CHPS患儿及50例对照组婴儿的幽门进行检测，比较其幽门肌层及黏膜层的厚度及血流分级。观察并比较CHPS患儿术前和胃镜下幽门肌切开术术后1 d、1周、1个月及6个月时幽门管各层组织的血流分布及血流参数的变化，同时观察造影剂通过幽门管情况及幽门管内径变化情况。结果 CHPS组与对照组的肌层及黏膜层厚度，肌层及黏膜层血流分级均具有显著统计学意义（均P＜0.01）。CHPS组与术前比较，术后1 d黏膜层血流更丰富；术后1周及1个月幽门管内径增宽，肌层变薄，术后6个月肌层厚度进一步变薄，肌层、黏膜层血流较术前稀疏减少，肌层Vmax减慢，RI减小。结论 通过彩色多普勒超声可观察胃镜下幽门切开术后幽门管各层组织血流变化规律，并可通过测量Vmax及RI以协助估计幽门狭窄的程度和手术疗效评估。 |
| 关键词: 超声检查，多普勒，彩色 幽门狭窄 胃镜 幽门肌切开术 |
| DOI： |
| 投稿时间：2017-12-19修订日期：2018-10-13 |
| 基金项目:类型：广东省科技计划项目 (No. 2014A020212014,2014A020212374) |
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| Doppler Ultrasound Evaluation of Gastroscopic Pylorictomy for Congenital Hypertrophic Pyloric Stenosis |
| ma sui hong,liu jian hua |
| () |
| Abstract: |
| Objective The purpose of this study was to evaluate the clinical value of Doppler ultrasound in the evaluation of the curative effect of pylorotomy under gastroscopy in the treatment of congenital hypertrophic pyloric stenosis （CHPS）. Methods The pylorus of 65 children with CHPS and 50 control infants were examined by Doppler ultrasonography. The thickness and blood flow grading of pyloric muscular layer and mucosal layer were compared. To observe and compare the changes of blood flow distribution and parameters of pyloric duct in children with CHPS before operation and 1 day, 1 week, 1 month and 6 months after gastroscopic pylorectomy.At the same time，the changes of the pylorus tube and the diameter of the pylorus tube were observed. Results The thickness of muscular layer and mucosal layer, blood flow grading of muscular layer and mucosal layer in CHPS group and control group were statistically significant(P＜0.01). In group CHPS, blood flow in mucosa was more abundant at 1 d after operation；after 1 weeks and 1 months of pyloric diameter，muscular layer thickness，6 months after surgery，muscle thickness further thinning，muscular layer and mucosa and submucosa blood flow compared with preoperative sparse reduced，Vmax and RI of muscle layer decreased. Conclusion By Doppler ultrasound，we can grasp the blood flow grading of pyloric canal mucosa after gastroscopic pylorotomy，and estimate the degree of pyloric stenosis by measuring Vmax and RI. It provides valuable clinical evidence for evaluating the effect of surgical treatment. |
| Key words: Color Doppler Ultrasonography Pyloric stenosis gastroscope Pyloromyotomy |
