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[肝硬化患者直肠壁的超声表现]

[Ultrasonographic aspect of the rectal wall in liver cirrhosis].

作者信息

Letard J C, Cessot F, Parneix J L, Liebaert M P, Le Sidaner A, Sautereau D, Pillegand B

机构信息

Service de Gastroentérologie et d'Hépatologie, Hôpital Universitaire Dupuytren, Limoges.

出版信息

Gastroenterol Clin Biol. 1994;18(4):342-7.

PMID:7958650
Abstract

The aim of this study was to assess the ultrasonographic abnormalities of the rectal wall and surrounding structures in patients with cirrhosis and to correlate these findings with endoscopy. From November 1992 to May 1993, 53 cirrhotic patients and 30 control subjects were examined by transrectal ultrasonography and rectoscopy. In addition to rectoscopy and transrectal ultrasonography, patients with cirrhosis underwent an upper gastrointestinal endoscopy. Ultrasonography abnormalities of the rectum were detected in 32 cases of cirrhosis (60.5%): a) in 21 cases the rectal wall thickness was greater than 5 mm and the sub-mucosa was thickened ( > or = 2 mm) and dissected by thin echo-free elements; b) the remaining 11 patients presented, in addition to the previously described abnormalities, rounded elongated echo-free structures surrounding the rectum which were not found in the control group. All these 11 patients had rectal varices at rectoscopy. In the group of cirrhotic patients, rectoscopy showed abnormal dilated veins in 23 cases (43.5%) and rectal varices in 11 cases. Ultrasonographic and endoscopic abnormalities of the rectum were more often visualized in the group of cirrhotic patients than in the control group (P < 0.001). In patients with cirrhosis, the demonstration of rectal varices was associated with transrectal ultrasound abnormalities (P < 0.01), and in particular peri-rectal vascular formations. In cases of cirrhosis the rectal wall abnormalities were not associated with gastric varices at endoscopic inspection but were linked with large esophageal varices or gastric mucosal abnormalities demonstrated on endoscopy (P < 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

本研究旨在评估肝硬化患者直肠壁及周围结构的超声异常情况,并将这些发现与内镜检查结果进行关联。1992年11月至1993年5月,对53例肝硬化患者和30例对照者进行了经直肠超声检查和直肠镜检查。除直肠镜检查和经直肠超声检查外,肝硬化患者还接受了上消化道内镜检查。32例肝硬化患者(60.5%)检测到直肠超声异常:a)21例患者直肠壁厚度大于5mm,黏膜下层增厚(≥2mm),并被薄的无回声区分隔;b)其余11例患者除上述异常外,直肠周围出现圆形细长无回声结构,对照组未发现。这11例患者直肠镜检查均有直肠静脉曲张。肝硬化患者组中,直肠镜检查显示23例(43.5%)静脉扩张异常,11例有直肠静脉曲张。肝硬化患者组直肠的超声和内镜异常比对照组更常见(P<0.001)。在肝硬化患者中,直肠静脉曲张的显示与经直肠超声异常相关(P<0.01),尤其是直肠周围血管形成。在肝硬化病例中,直肠壁异常与内镜检查时的胃静脉曲张无关,但与内镜检查显示的大食管静脉曲张或胃黏膜异常有关(P<0.01)。(摘要截短至250字)

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