Svanes C, Salvesen H, Bjerke Larssen T, Svanes K, Søreide O
Dept. of Surgery, University of Bergen, Haukeland Hospital, Norway.
Scand J Gastroenterol. 1990 Mar;25(3):257-62.
The trends in and value and consequences of radiologic imaging in 1128 patients with perforated gastroduodenal ulcer have been studied over the 50-year period 1935-1985. The proportion of patients undergoing plain X-ray studies increased from 4% in the first 5-year period (1935-1939) to 94% in the last (1980-1985). Pneumoperitoneum was found in 77% of those undergoing X-ray studies. Water-soluble contrast studies were introduced in 1960, and in the three 5-year periods 1970-1985 from 8% to 13% underwent such imaging. Leakage was demonstrated in 60% of those undergoing contrast studies. Contrast studies have had a limited role in the pretreatment evaluation of these patients. The frequency of pneumoperitoneum was fairly constant over the 50-year period, and the only patient characteristic that influenced the occurrence of free gas in the abdominal cavity was age, with a higher proportion of patients with pneumoperitoneum in old patients. Any radiologic study increased treatment delay by at least 2 h.
对1935年至1985年这50年间1128例胃十二指肠溃疡穿孔患者的放射影像学检查趋势、价值及后果进行了研究。接受普通X线检查的患者比例从第一个5年期间（1935 - 1939年）的4%增至最后一个5年期间（1980 - 1985年）的94%。在接受X线检查的患者中，77%发现有气腹。水溶性造影剂检查于1960年开始应用，在1970年至1985年的三个5年期间，有8%至13%的患者接受了此类检查。在接受造影剂检查的患者中，60%显示有渗漏。造影剂检查在这些患者的预处理评估中作用有限。在这50年期间，气腹的发生率相当稳定，影响腹腔内游离气体出现的唯一患者特征是年龄，老年患者中气腹患者的比例更高。任何放射学检查都会使治疗延迟至少2小时。
