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.
【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。
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.
ObjectiveTo evaluate the efficacy of western conventional treatment based on traditional Chinese medicine retention enema on patients with hepatic encephalopathy. MethodsSuch databases as the Cochrane Library, PubMed, EMbase, VIP, CNKI, CBM and WanFang Database were searched from the inception to November 2013 to collect randomized controlled trials (RCTs) about Western conventional treatment based on traditional Chinese medicine retention enema to treat hepatic encephalopathy, and the references of the included literature were also retrieved. Two reviewers independently screened the literature according to the inclusion and exclusion criteria, extracted the data, and evaluated and cross-checked the methodological quality. Then meta-analysis was conducted using RevMan 5.1 software. ResultsA total of 26 RCTs involving 1 691 patients were included. The subgroup analyses based on the length of intervention time showed that when the course of treatment intervention was less than one, the overall effective rate of the Chinese herbal retention enema group was higher than that of the control group, with a significant difference[RR=1.34, 95%CI (1.25, 1.44), P<0.000 01]; after more than one course of treatment intervention, the overall effective rate of the Chinese herbal retention enema group was higher than that of the control group, with a significant difference[RR=1.34, 95%CI (1.21, 1.48), P<0.000 01]. ConclusionOn the basis of available evidence, the western medicine treatment based on traditional Chinese medicine retention enema for hepatic encephalopathy has a certain effect. However, the heterogeneity among the included studies is large. It is necessary to design multicenter, strictly randomized and double-blind test controlled trials with large samples to validate these conclusions and to further confirm the clinical curative effect.
目的 探讨婴幼儿肠套叠空气灌肠复位的指征、操作方法和中转手术的时机。方法 对我院1993～1998年5年间在X线透视下行空气灌肠复位治疗的婴幼儿肠套叠162例进行回顾性分析。结果 复位成功者148例，成功率为91.4%，其余14例中转手术治疗。随访1～5年，预后良好。结论 空气灌肠复位是婴幼儿肠套叠早期治疗的首选 方法，应谨慎把握其适应证，熟练掌握操作方法，不应轻易放弃而过早手术。但对病程较长，伴有腹膜炎体征或复位失败者，须及时手术治疗。