| Objective:1,To study the clinical significance of the lipiodol angiography in the diagnosis and treatment of small bowel obstruction; 2,To study the usage value of the lipiodol angiography in directing the treatment-choice used in small-bowel obstruction, and the best selection of observing-time in the visualization.3,To explore the compatible therapeutic effect of the lipiodol angiography used in small-bowel obstruction;4,To analysis the advantage between the iodized oil and other contrast.Materials and Methods: According to inclusion criteria and exclusion criteria to choose 183 patients who are suspected as small intestinal obstruction by clinical and upright abdominal X-ray film. Randomly dividing the patients into iodized oil group (Group A) 103 cases ,cardiografin group (Group B) 52 cases, plain abdominal X-ray group (Group C) 28 cases, then having a dynamic observation with abdominal X-ray.1,In group A and B, making whether contrast agent get into the colon as the standard to direct the choice of the treatment measure (conservative or surgical),then applied in diagnosis and treatment of small bowel obstruction. Investigation was made on the consistency between whether the lipiodol reach colon after injection and whether to perform final surgical therapy on patients, Kappa analysis of the consistency was made; in group C, doing adjustment of treatment based on clinical manifestations. 2,In group A,B,observing the results of colon-arrival rate of the contrast agent at 4h,8h,16h,24h,36h time points,then comparing the arrival rate. 3,In group A,B,C, the result of diagnosis and treatment of small bowel obstruction were compared. 4,Observing the abdominal radiography results of group A,B at 4h,8h,16h,24h,36h time points,comparing the rat,time limit of visualization between group A and B. 5,To got the therapeutic effect and of the patients in 3 groups through questionnaire, then comparing the therapeutic effect among these samples. 6,To got the untoward effect of the patients in 3 groups through questionnaire, then comparing the therapeutic effect among these samples.Results: 1,In group A , making a consistency analysis between whether the lipiodol reach colon after injection and whether to perform final surgical therapy on patients, the Kappa score is 0.930 P=0.00; lipiodol group is a little better than the cardiografin group(group B) which Kappa score is 0.808,P=0.00. 2,In the gastrointestinal contrast, during the 24h the rate of arrival of the colon is trend to a gradual increase, after 24h the arrival rate will remain basically unchanged, so 24h is the best time limit to observe whether contrast agent get into the colon. 3,Comparing the precision-treatment rate,sensitivity,specificity between lipiodol angiography and hysterosalpingography in the diagnosis and treatment of small bowel obstruction, the precision-treatment rate of lipiodol angiography is little better (P<0.1), there was no significant difference in sensitivity,specificity (P>0.05); the precision-treatment rate,sensitivity,specificity of lipiodol angiography are better than plain abdominal X-ray. 4,Comparing the visualization rate between group A and group B, there was no significant difference among 4h,8h,16h, group A is significant better then group B at 24h,36h. 5,Comparing curative effect among group A,group B,group C, there was no significant difference(P>0.05), iodized oil has a considerable curative effect compare with cardiografin and paraffin oil. 6,There is a little untoward effect in lipiodol enterography, and no significant difference of untoward effect among group A,B,C(P>0.05).Conclusion:1,Whether the contrast agent arrive at the colon is instructive for the choice of conservative or surgical treatment of small bowel obstruction. 2,Directing the diagnosis and treatment of small bowel obstruction,the effect of lipiodol enterography is slightly better than that of hysterosalpingography ,significantly better than the abdominal pail film's. 3,For the diagnosis and treatment of small bowel obstruction, the effect and the time limit of imaging of the lipiodol enterography is better than that of the hysterosalpingography. 4,The lipiodol has therapeutic effect of small bowel obstruction. 5,The lipiodol enterography hasn't significant untoward effect. Objective: To explore the safety of the lipiodolin enterography used in the diagnosis and treatment of small bowel obstruction.Materials and Methods: Randomly selecting 20 cases from the iodized oil group in the first part to compose of the experimental group (Group A); the control group (B group) is consisted of 15 patients with other diseases except of intestinal obstruction in the department of general surgery and normal volunteers. According to the first part, the oral iodized oil (40ml) imaging are used in Group A, and the vegetable oil (40ml) is given in Group B. 1,Before the imaging, and 2 days, 6 days after imaging, getting blood of the people in Group A to test blood routine,liver and kidney function,thyroid function,serum iodine, so do in Group B before the people treated with vegetable oil. 2,Before the imaging, and 2 days, 6 days after imaging, getting urine of the people in Group A to test urine iodine, so do in Group B. 3,To got the adverse reactions of the patients after treated with reagents in Group A, Group B.Result: Comparing blood routine,liver and kidney function,thyroid function between before and after imaging in Group A, between Group B and after imaging in Group A, there are no significant difference, P>0.05. 2,Comparing serum iodine, urine iodine between Group A before imaging,Group B and 2 days after imaging in Group A , there are significant difference P<0.05, between Group A before imaging,Group B and 6 days after imaging in Group A, P>0.05. The serum iodine, urine iodine increase after imaging, returned to normal in 10 days. 3,Comparing the adverse reactions between Group A and Group B, P>0.05, there are no significant difference.Conclusion: Lipiodol angiography (40ml) is safe and reliable for the patients with small bowel obstruction. |
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