| Gastroesophageal reflux disease(GERD)refers to the disease of esophageal mucosa damage caused by excessive exposure to gastric fluid in the esophageal cavity.In the whole process of the rapid development of modern science and technology,contrast ultrasound has been widely used in clinical medicine.Contrast-enhanced ultrasound is the use of contrast agents contrast agents to produce density differences of different substances,and then use ultrasound to treat the disease of the institutions and all the normal institutions to identify.Gastrointestinal contrast-enhanced ultrasound can be used to determine the presence of gastroesophageal reflux in patients with intuitive anatomical images.Gastrointestinal contrast-enhanced ultrasonography has ideal diagnostic value for gastroesophageal reflux disease.It is feasible in people with gastroscopy contraindications such as severe pulmonary infection,hypertension and severe coronary heart disease.The purpose of this study was to investigate the anatomical significance of contrast-enhanced ultrasound(CEUS)in gastroesophageal reflux.Methods: Gastrointestinal barium meal examination was performed in the control group: all patients were kept fasting for at least 8 hours before examination.Basic Xray apparatus(Agilent UC-50S)was used,barium sulfate suspension was taken orally before examination,the subject activity was rotated and placed in a flat position,and film photos of esophagus and stomach were taken.His Angle is selected as the intersection Angle between the right medial fundus of the stomach and the lesser gastric curvature that crosses the axis of the esophagus at 90°.The research team performed a comparison of gastric flushing ultrasonography.Before diagnosis,patients were told to abstain from water and food for 8 hours.Use boiling water(450 ～ 550 m L;90-100 ℃)to help the gastrointestinal ultrasound display the dosage(dosage of the drug was 50g)for preparation.For patients with heavier and higher body weight,the amount of boiled water should be increased appropriately.When the medicine cools,let the patient drink it and take it.Color Doppler ultrasonography was performed.The order of examination is: the esophagus and the abdominal part of the pylorus;The size of the fundus and the curvature of the gastric body and the left and right anterior and posterior walls;Stomach Angle;Gastric body and duodenum.Give the patient a certain amount of contrast agent.The camera was placed under the patient’s xiphoid process and above the slightly inclined incision,with a long/short axis cross-section method selected and a full view of the abdomen of the esophagus and the pylorus was made.Contrast-enhanced ultrasonography was performed strictly in the order of examination.The length of His Angle and abdominal esophagus of all subjects was accurately measured using the ultrasound AIXplorer color Doppler ultrasound equipment of the Department of Acoustics.Measurement method: basically did not eat for 8-12 hours before the precise measurement,500 m L of contrast medium was taken 5 minutes before the precise measurement,placed horizontal,the oblique section of the left costal margin was selected under the xiphoid process,and the subject inhaling and holding the breath was instructed to hold the breath,the left septum of the liver was directed towards the lens,and force was applied to the abdominal cavity.The Angle between the straight line of the short axis of the esophagus and the dashed line of the gastric fundus is HIS Angle.The length of the abdominal esophagus is the distance between the opening of the esophageal foramen and the opening of the pylorus.Results: 1.The occurrence of hiatal hernia is related to the large surface area of the esophageal hiatus,which is more likely to cause gastroesophageal reflux disease.2.Comparison between the length of abdominal esophagus and His Angle in the study group: The study group chose two methods of gastric cleaning ultrasound and gastrointestinal barium meal examination to detect the length of His and His Angle.Abdominal esophagus.There was no statistical significance(P> 0.05).3.Comparison of ce US results between the two groups: data showed that the length of abdominal cavity and esophagus in the experimental group was lower than that in the control group,and the other Angle was better in the control experiment(P <0.01).4.Occurrence frequency and duration of GERD within 5 min: The mean occurrence frequency and duration of GERD within 5 min in subjects were significantly higher than those in control group,and the difference in aspect ratio was statistically significant(P < 0.01).5.Pathologic and physiological GASTROesophageal reflux disease: the diagnostic rate of physiological reflux disease in the control group was significantly higher than that in the physical and mental health group,and the difference in diagnostic rate was statistically significant(P<0.01).Compared with the control group,the difference was statistically significant(P <0.01).6.The value of color Doppler ultrasonography of abdominal esophageal length and His Angle in the diagnosis of GERD is meaningful.The sensitivity of His Angle to GERD was 80.00 %.The nonspecific rate was 85.68%.The sensitivity and nonspecificity of abdominal esophageal length to the diagnosis of GERD were 72.86%,74.34% respectively.7.Correlation analysis between the length of the abdominal esophagus and his Angle: According to the data obtained from gastric ce US,Pearson correlation analysis showed that the length of the abdominal esophagus in the observation group was negatively correlated with his Angle(P < 0.01).8.The scores of SCL-90,SAS and SDS in the two groups: the scores of somatization,compulsion,depression,anxiety and terror symptoms in the study group were significantly higher than those in the control group(P < 0.05);SAS score of GERD group was(42.72±9.48)points,SDS score was(47.62±11.87)points,and control group was(37.34±12.59)points,(42.03±10.61)points,the difference between the two groups was statistically significant(P < 0.05).Conclusion: Gastrointestinal contrast-enhanced ultrasonography does not affect the anatomical structure of patients.It has the advantages of simple and convenient operation,high diagnostic rate,less pain and economic benefits.It is is worthy of promoting and using in clinical practice. |
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