Izumoto G, Takahashi H, Kitagishi H, Sakata I, Yasutomi M, Yamamoto T
Critical Care Medical Center, Kinki University Hospital, Osaka, Japan.
Nihon Geka Gakkai Zasshi. 1991 Jan;92(1):12-6.
One hundred ml of Gastrografin was administered through the gastric tube to each of ten subjects with duodenal ulcer perforation and to each of twenty subjects which had no gastrointestinal perforation. Urine was collected from the subjects every 10 minutes up to 180 minutes following the administration of gastrogratin. The iodine level of every urine sample was assayed using inductively coupled plasma atomic emission spectrometry. The iodine level of seven subjects with open duodenal ulcer perforation was higher than the mean +2 = SD of urine from the subjects without gastrointestinal perforations. Two of the subjects had no leakage of Gastrografin demonstrated intra-abdominally during an upper gastrointestinal series. The urine iodine level of subjects with closed duodenal perforation was lower than the mean +2 X SD of urine from the subjects without gastrointestinal perforations. One of the subjects was selected non-surgical therapy, and two other subjects which underwent emergent surgery may also have been candidates for non-surgical therapy, as suggested by its indications. The above results suggest that patients with duodenal ulcer perforation but without intra-abdominal leakage of Gastrografin and urine iodine level lower than the mean +2 X SD of urine from subjects without gastrointestinal perforation following Gastrografin administration may be selectable for non-surgical therapy.
给10名十二指肠溃疡穿孔患者和20名无胃肠道穿孔患者分别经胃管注入100毫升泛影葡胺。在注入泛影葡胺后的180分钟内，每隔10分钟收集一次受试者的尿液。使用电感耦合等离子体原子发射光谱法测定每个尿液样本的碘含量。7名开放性十二指肠溃疡穿孔患者的尿液碘含量高于无胃肠道穿孔患者尿液均值加2个标准差。在上消化道造影检查中，有2名受试者腹腔内未显示泛影葡胺渗漏。闭合性十二指肠穿孔患者的尿液碘含量低于无胃肠道穿孔患者尿液均值加2倍标准差。有1名受试者选择了非手术治疗，另外2名接受急诊手术的受试者根据其指征也可能是非手术治疗的候选者。上述结果表明，十二指肠溃疡穿孔但无腹腔内泛影葡胺渗漏且注入泛影葡胺后尿液碘含量低于无胃肠道穿孔患者尿液均值加2倍标准差的患者可能适合非手术治疗。
