基于二氧化碳介质的小肠仿真内镜模拟实验研究

发布时间：2018-01-01 18:07

本文关键词：基于二氧化碳介质的小肠仿真内镜模拟实验研究　出处：《中国内镜杂志》2016年10期 　论文类型：期刊论文

【摘要】：目的探讨临床应用二氧化碳CO_2作为造影介质进行小肠CT仿真内镜检查(CTVE)的可行性。方法取新鲜猪空肠标本30段,于每段空肠标本内壁模拟制作同等直径、高度分别为5、10和15 mm大小的模拟占位各3枚。随机把30段空肠模型分为CO_2组、空气组和充水组3组,每组各10段,模拟占位各30枚,行多层螺旋CT扫描,利用工作站进行成像,比较应用不同造影介质的充盈方法对猪空肠占位性病变的检出情况、占位性病变的显示效果评分。结果 CO_2组、空气组和充水组CTVE对猪空肠占位性病变的检出率分别为90.00%、86.67%和76.67%,CO_2组与空气组效果相当(P0.05),与充水组比较差异有统计学意义(P0.01)。在模拟占位高度为5和10 mm时,CO_2组和空气组评分均优于充水组(P0.01);模拟占位高度为15 mm时,CO_2组、空气组评分与充水组评分比较均无明显差异(P0.05)。结论离体猪空肠实验提示CO_2可替代空气作为小肠CTVE的新型造影介质,临床实际应用有待进一步大规模临床随机对照试验证实。
[Abstract]:Objective to explore the feasibility of CT virtual endoscopy of small intestine using carbon dioxide CO_2 as the medium of contrast examination. Methods 30 segments of fresh porcine jejunum were collected. The model of 30 segments of jejunum was randomly divided into CO_2 group with the same diameter and height of 5 10 mm and 15 mm in the inner wall of each jejunum. Air group and water filling group, 10 segments in each group, 30 simulated space occupying, performed multi-slice spiral CT scanning and imaging by workstation. The detection of space occupying lesions of jejunum in pigs was compared with the filling methods of different imaging mediums. Results CO_2 group was used to evaluate the display effect of space occupying lesions. The detectable rates of CTVE in air group and water filled group were 90.0086.67% and 76.67% respectively in jejunum occupying lesion. The effect of CTVE in group 2 was similar to that in air group (P 0.05). When the simulated occupation height was 5 mm and 10 mm, the scores of COSP 2 and air group were better than that of water filling group (P 0.01). When the simulated occupation height was 15 mm, there were two groups of COS. There was no significant difference between the air group and the water-filled group. Conclusion the isolated pig jejunum test suggests that CO_2 can replace air as a new medium for small intestinal CTVE. The clinical application needs to be confirmed by further large-scale randomized controlled trials.
【作者单位】：广东省佛山市第五人民医院消化内科;
【基金】：佛山市医学类科技攻关项目(No:2014B00393) 省级重点医学专科培育项目建设资金(No:Fspy3-2015027)
【分类号】：R574.5
【正文快照】： 随着胶囊内镜和双气囊小肠镜的出现及临床应用技术的发展,小肠疾病的检查和诊断由原来的技术难点逐步变得较为容易[1-3]。但由于双气囊小肠镜价格昂贵、是介入性检查,操作技术难度高,患者有一定痛苦,导致其还未能普及开展;胶囊内镜在临床上也有其局限性;而小肠CT仿真内镜(comp

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