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目的观察慢性放射性直肠炎的经直肠超声表现。方法对52例晚期宫颈癌放疗后发生慢性放射性直肠炎患者行经直肠超声检查,其中7例已行横结肠造瘘(造瘘组),45例未行横结肠造瘘术(非造瘘组),采用二维灰阶超声观察并记录可探及范围内直肠肠壁厚度和层次、溃疡及直肠阴道瘘等情况;能量多普勒观察肠壁血流,并根据Limberg标准进行分级。分析肠壁厚度与血供分级的相关性;比较造瘘组与非造瘘组患者病变肠壁厚度、血流情况。结果 52例患者病变肠壁平均厚度(7.88±2.05)mm,肠壁血供Ⅲ~Ⅳ级35例(35/52,67.31%);肠壁厚度与血供分级存在相关性(rs=0.48,P<0.01);造瘘组与非造瘘组患者肠壁厚度、血供分级的差异均有统计学意义(P均<0.05)。结论慢性放射性直肠炎的经直肠超声特征性表现为病变肠管壁弥漫性增厚、血流信号增多。
Objective To observe the transrectal ultrasound manifestations of chronic radiation proctitis. Methods Transrectal ultrasonography was performed in 52 patients with advanced cervical cancer after radiotherapy. Among them, 7 patients underwent transverse colostomy (fistula) and 45 patients underwent transverse colostomy (non-fistula) Two-dimensional gray-scale ultrasonography was performed to observe the thickness and layer of rectal wall, ulcer and rectovaginal fistula in the range of probing, and the intestinal wall blood flow was observed by energy Doppler and graded according to Limberg standard. The correlation between the thickness of the intestinal wall and the grading of the blood supply was analyzed. The thickness of the intestinal wall and blood flow were compared between the patients in the ostomy group and the non-ostomy group. Results The average thickness of the intestinal wall in the 52 patients was 7.88 ± 2.05 mm, and the blood supply in the intestinal wall was 35 to 52 and 67.31% in the grade Ⅲ to Ⅳ. There was a correlation between the thickness of the intestinal wall and the grade of blood supply (rs = 0.48, P <0.01). There was significant difference in intestinal wall thickness and blood grade between fistula group and non-fistula group (all P <0.05). Conclusion The characteristics of transrectal ultrasound of chronic radiation proctitis are diffuse thickened gut wall and increased blood flow signal.