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目的探讨冲洗胃内液后行X线常规胃低张双重对比造影,对鉴别胃内早期癌及良性小溃疡的细微病变的价值。方法搜集经临床和手术、胃镜活检证实的100例,其中早期胃癌58例,良性溃疡30例,糜烂萎缩性胃炎12例。采用抑制胃内分泌液药物与插管注入氯化钠(包括西皮Ⅱ粉)冲洗排除胃内残液,然后行X线常规胃低张双重对比造影(“双连法”)以显示胃内微细早期癌及良性病变进行图像分析及统计。结果发现58例早期胃癌(Ⅱa型8例,Ⅱb型4例,Ⅱc型12例,Ⅲ型20例,Ⅱc+Ⅲ型14例),主要表现为“火山口”征、胃壁“双轨”征、基底凹凸不平“指压”征及“杵状”征,是鉴别良恶性病变依据。另30例良性溃疡表现为“星光状”,其周围黏膜纠集,自远而近由粗变细不中断,基底光整。12例糜烂萎缩性胃炎表现为小点状龛影,形态圆形,少数呈不规则、周围小透亮带及小环圈。结论“双连法”在鉴别诊断中有一定优势,可显示病变周边细微变化,可明确病变大小范围,易显示对胃前后壁隆起或凹陷性病变、浅表性凹陷病变。veinfovce可弥补常规双重造影不足,正确熟练应用可以明显提高早期胃癌诊断率。
Objective To investigate the value of double contrast conventional gastric low contrast after irrigating the gastric fluid in the diagnosis of small lesions of early gastric cancer and benign small ulcer. Methods 100 cases confirmed by clinical and surgical endoscopy and biopsy were collected, including 58 cases of early gastric cancer, 30 cases of benign ulcer and 12 cases of atrophic gastritis. Gastric endocrine drugs and intubation with sodium chloride inhibition (including the West Cortex II powder) rinse to exclude residual gastric fluid, and then double X-ray routine gastric contrast double contrast (“double connection method”) to show the early gastric fine Cancer and benign lesions for image analysis and statistics. 58 cases of early gastric cancer were found (8 cases of type Ⅱa, 4 cases of type Ⅱb, 12 cases of type Ⅱc, 20 cases of type Ⅲ and 14 cases of type Ⅱc + Ⅲ). The main manifestations were “crater” sign, “double track” Base uneven “Shiatsu” sign and “clubbing” sign, is to identify the basis of benign and malignant lesions. The other 30 cases of benign ulcer manifested as “star-shaped”, the surrounding mucosa gathered from the far and near by the coarse and fine is not interrupted, the basal smoothing. 12 cases of erosion of atrophic gastritis showed little punctate niche shadow, the shape of a circle, a few irregular, around the small band and a small ring. Conclusions “Shuanglian method” has some advantages in differential diagnosis. It can show subtle changes around the lesion and can confirm the range of the lesion size. It is easy to show the uplift or depression of the anterior and posterior gastric wall and the superficial depressed lesions. Veinfovce can make up for the lack of conventional double contrast, correct and skilled application can significantly improve the diagnosis rate of early gastric cancer.