ObjectiveTo investigate the diagnostic value of intra-intestinal angiography CT in patients with anastomotic leakage (AL) after rectal cancer resection.MethodsPatients who admitted to The Department of General Surgery of The No. 900 Hospital of The Joint Logistic Team from January 2013 to October 2018, who were diagnosed with rectal cancer and underwent rectal cancer resection with sphincter preserving surgery, were retrospectively collected in the study. All patients underwent routine imaging examination on the 7th day after rectal cancer operation. The retrograde contrast enema (RCE) was performed to obtain the abdominal X-ray film, then the pelvic CT scan was performed to get the CT image of the intestinal lumen. The films were reviewed by 2 senior radiologists, and the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of RCE and intra-intestinal angiography CT in the diagnosis of AL after rectal cancer resection were evaluated. Evaluated the sensitivity of the CT image feature to predict AL after rectal cancer resection.ResultsThe sensitivity, specificity, PPV, and NPV of RCE in the diagnosis of AL after the rectal cancer resection were 69.23% (18/26), 98.64% (218/221), 85.71% (18/21), and 96.46% (218/226) respectively. The sensitivity, specificity, PPV, and NPV of intra-intestinal angiography CT were 96.15% (25/26), 99.09% (219/221), 92.59% (25/27), and 99.54% (219/220) respectively. The sensitivity and NPV of intra-intestinal angiography CT in diagnosis of AL were significantly higher than those of RCE (P<0.05). The sensitivity of contrast agent leakage to diagnosis of AL was the highest, reaching 96.15% (25/26).ConclusionsThe sensitivity of intra-intestinal angiography CT in the diagnosis of AL is high and the overall diagnostic efficiency is better than RCE, and the leakage of contrast agent is the main imaging feature of AL. It is significant to guide the clinical practice.
ObjectiveTo improve the efficacy of colon doublecontrast barium enema examination by using digital gastrointestinal machine and modified enema techniques. MethodsSixtyfour patients were examined on digital remote controlled gyration table, with oral coloncleansing preparation and selfmade disposable plastic bag. Results In 64 patients, up to 93.8% were found with none or little fecal materials in the cecum and ascending colon. 80% of the results were scored excellent, and 95% were accurate for making diagnosis. All the patients underwent the examination successfully. ConclusionDigital gastrointestinal machine examination combined with modified hypotonic doublecontrast barium enema is a simple, convenient and efficient way to clearly demonstrate colonic mucosa, and help increase the detection and diagnosis rate.
【摘要】目的探讨成人肠套叠的临床特点和诊治原则。方法对1980年1月至2004年2月期间我院收治的167例成人肠套叠临床资料进行回顾性分析。结果术前确诊79例，占47.3%。167例中159例行手术治疗，其中116例为肠道肿瘤,良性48例，恶性68例； 余51例为手术或外伤后、肠道炎症、盲肠过长等。共有117例行肿瘤根治性切除术或相应肠段切除术，50例行单纯复位或复位后固定术。2例术后死亡，余均恢复良好，134例随访2个月～10年，无肠套叠复发。结论提高对成人肠套叠的认识是诊断的关键，检查应选用B超、CT、钡灌肠等，治疗则首选手术治疗。
目的 评价中药灌肠治疗各型便秘的疗效。 方法 计算机检索CBM、VIP、CNKI及Cochrane图书馆临床对照试验数据库等，查找符合纳入标准的随机对照试验，文献检索时间均从建库截至2012年5月。并按Cochrane系统评价手册的文献质量评价办法评价纳入研究的方法学质量，而后提取相关数据用Rev Man 5.1软件进行Meta分析。 结果 最终纳入15篇随机对照试验，共1 137名受试者。结果显示：中药灌肠治疗各型便秘的效果优于口服药、肥皂水灌肠、开塞露等其他治疗，OR值及相应95%CI分别为6.6（2.61，16.69）、5.46（2.57，11.60）、6.54（2.41，17.70）。 结论 中药灌肠治疗便秘有一定疗效且相对安全。由于纳入分析的研究质量差异较大，因此有必要进行大样本、多中心、随机、双盲的对照试验，以进一步证实其临床疗效。