ObjectiveTo improve the efficacy of colon doublecontrast barium enema examination by using digital gastrointestinal machine and modified enema techniques. MethodsSixtyfour patients were examined on digital remote controlled gyration table, with oral coloncleansing preparation and selfmade disposable plastic bag. Results In 64 patients, up to 93.8% were found with none or little fecal materials in the cecum and ascending colon. 80% of the results were scored excellent, and 95% were accurate for making diagnosis. All the patients underwent the examination successfully. ConclusionDigital gastrointestinal machine examination combined with modified hypotonic doublecontrast barium enema is a simple, convenient and efficient way to clearly demonstrate colonic mucosa, and help increase the detection and diagnosis rate.
【摘要】目的探讨成人肠套叠的临床特点和诊治原则。方法对1980年1月至2004年2月期间我院收治的167例成人肠套叠临床资料进行回顾性分析。结果术前确诊79例，占47.3%。167例中159例行手术治疗，其中116例为肠道肿瘤,良性48例，恶性68例； 余51例为手术或外伤后、肠道炎症、盲肠过长等。共有117例行肿瘤根治性切除术或相应肠段切除术，50例行单纯复位或复位后固定术。2例术后死亡，余均恢复良好，134例随访2个月～10年，无肠套叠复发。结论提高对成人肠套叠的认识是诊断的关键，检查应选用B超、CT、钡灌肠等，治疗则首选手术治疗。
【摘要】 目的 比较肠充盈超声检查法与常规经腹超声检查法在结直肠肿瘤中的诊断价值。 方法 对2008年6月-2009年6月64例经临床病理确诊的结直肠肿瘤患者分别经腹常规超声及肠充盈超声检查。在肠充盈状态下观察病变的形态，对病变进行定位并观察结直肠肿瘤的彩色多普勒血流信号。比较肠充盈超声检查法及常规经腹超声检查法在结直肠肿瘤的检出、定位和显示血流的能力的差异。 结果 常规经腹部超声检查发现32例结直肠肿瘤（32/64），病灶敏感性为50%； 肠充盈超声检查法发现病灶55例（55/64）， 病灶敏感性为85.9%。经腹常规超声检查的定位准确率为21.9%（7/32），肠充盈超声检查法对结直肠肿瘤的定位准确率为89.1%（49/55）。两种方法比较差异有统计学的意义（Plt;0.05）。 结论 肠充盈超声检查法在结直肠肿瘤的病变敏感性检出、定位准确性等方面优于经腹常规超声检查；而不同病理类型的结直肠肿瘤具有不同的超声声像图特征。【Abstract】 Objective To compare the diagnostic value between intraluminal contrast-enhanced hydrocolon ultrasonography and conventional transabdominal ultrasonography for of colorectal neoplasms. Methods The conventional transabdominal ultrasonography and hydrocolonic ultrasonography using an intraluminal contrast agent were performed on 62 patients from June 2008 to June 2009. The morphological features and location of the lesion were observed and the blood flow signals were observed. The different diagnostic value between conventional transabdominal ultrasonography and intraluminal contrast-enhanced hydrocolon ultrasonography was compared. Results The sensitivity of the intraluminal contrast-enhanced hydrocolon ultrasonography in the depiction of the colorectal neoplasms (55/64, 85.9%) was higher than that of the conventional transabdominal ultrasonography (32/64, 50%, Plt;0.05). And the accuracy of the intraluminal contrast-enhanced hydrocolon ultrasonography in locating the colorectal neoplasms (48/55, 87.3%) was higher than that of the conventional transabdominal ultrasonography (7/32, 53.2%, Plt;0.05). Conclusion Intraluminal contrast-enhanced hydrocolon ultrasonography is more valuable for colorectal neoplasms than conventional transabdominal ultrasonography in detecting and locating colorectal neoplasms. Colorectal neoplasms with different pathological types may have different ultrasonic features.
Objective To evaluate the effectivenss of Chinese herbal retention enema in viral hepatitis patients. Methods Such databases as The Cochrane library, PubMed, EMbase, VIP, CNKI, CBM and WanFang Data were searched from the inception to December, 2011 to collect the randomized controlled trials (RCTs) about Chinese herbal retention enema in treating viral hepatitis, and the references of the included literature were also retrieved. Two reviewers independently screened the literature according to the inclusion and exclusion criteria, extracted the data, and evaluated and cross-checked the methodological quality. Then meta-analysis was conducted using RevMan 5.0 software. Results A total of 20 RCTs involving 1 735 patients were included. The subgroup analyses based on the length of intervention time showed that: a) after 2-week intervention: the overall effective rate of the Chinese herbal retention enema group was higher than that of the control group, with a significant difference (OR=3.19, 95%CI 1.87 to 5.44, Plt;0.000 1). Compared with the control group, the Chinese herbal retention enema group better promoted the recovery of liver function by more reduction of AST (MD= ?82.50, 95%CI ?145.66 to ?19.34, P=0.01), ALT (MD= ?44.78, 95%CI 65.90 to ?23.66, Plt;0.000 1) and TBIL (MD= ?37.51, 95%CI ?74.07 to ?0.95, Plt;0.0001). b) After 1-month intervention: The overall effective rate of the Chinese herbal retention enema group was higher than that of the control group, with a significant difference (OR=4.17, 95%CI 2.37 to 7.32, Plt;0.000 01). Compared with the control group, the Chinese herbal retention enema group better promoted the recovery of liver function by more reduction of AST (MD= ?17.86, 95%CI ?29.97 to ?5.76, P=0.004), ALT (MD= ?27.84, 95%CI ?42.45 to ?13.24, P=0.000 2), and TBIL (MD= ?54.15, 95%CI ?116.52 to ?8.23, P=0.09). Conclusion Chinese herbal retention enema can improve the overall effective rate for viral hepatitis patients, alleviate virus damage to liver cell and promote liver function recovery. The commonly used Chinese medicinals for enema are Radix et Rhizoma Rhei, Herba Artemisiae Capillaris, Salvia miltiorrhiza, and Radix Paeoniae Rubra.
ObjectiveTo systematically review the efficacy of Chinese herbal enema in ileus patients. MethodsThe randomized controlled trials (RCTs) and quasi-RCTs about Chinese herbal enema and gastrointestinal intubation versus western medicines in the treatment of ileus disease was searched in PubMed, Web of Science, EMbase, The Cochrane Library (Issue 4, 2013), CBM, CNKI, VIP and WanFang Data from the date of their establishment to July 2013. Two reviewers independently screened literature according to the inclusion and exclusion criteria, extracted data, and assessed the methodological quality of included studies. Then meta-analysis was performed using RevMan 5.1. ResultsA total of 27 RCTs and 3 quasi-RCTs involving 3 074 patients were included. The results of meta-analysis showed that the Chinese herbal enema and gastrointestinal intubation group was superior to the control group in raising the total clinical effective rate (OR=4.69, 95%CI 3.70 to 5.94, P < 0.000 01), as well as shortening the hospitalization time (SMD=-1.19, 95%CI-1.42 to-0.96, P < 0.000 01), time of anus exhaust (SMD=-1.52, 95%CI-1.76 to-1.28, P < 0.000 01), defecation (SMD=-2.27, 95%CI-3.43 to-1.11, P=0.000 1), time of gastric tube indwelling (SMD=-1.56, 95%CI-1.86 to-1.27, P < 0.000 01), and symptoms complete resolution (SMD=-0.74, 95%CI-1.11 to-0.37, P < 0.000 1), all with significant differences. ConclusionChinese herbal enema and gastrointestinal intubation is more beneficial than western medicine alone for ileus. Due to limited quality of the included studies, the abovementioned conclusion still needs to be verified by conducting more high quality blinding RCTs.
ObjectiveTo investigate the diagnostic value of intra-intestinal angiography CT in patients with anastomotic leakage (AL) after rectal cancer resection.MethodsPatients who admitted to The Department of General Surgery of The No. 900 Hospital of The Joint Logistic Team from January 2013 to October 2018, who were diagnosed with rectal cancer and underwent rectal cancer resection with sphincter preserving surgery, were retrospectively collected in the study. All patients underwent routine imaging examination on the 7th day after rectal cancer operation. The retrograde contrast enema (RCE) was performed to obtain the abdominal X-ray film, then the pelvic CT scan was performed to get the CT image of the intestinal lumen. The films were reviewed by 2 senior radiologists, and the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of RCE and intra-intestinal angiography CT in the diagnosis of AL after rectal cancer resection were evaluated. Evaluated the sensitivity of the CT image feature to predict AL after rectal cancer resection.ResultsThe sensitivity, specificity, PPV, and NPV of RCE in the diagnosis of AL after the rectal cancer resection were 69.23% (18/26), 98.64% (218/221), 85.71% (18/21), and 96.46% (218/226) respectively. The sensitivity, specificity, PPV, and NPV of intra-intestinal angiography CT were 96.15% (25/26), 99.09% (219/221), 92.59% (25/27), and 99.54% (219/220) respectively. The sensitivity and NPV of intra-intestinal angiography CT in diagnosis of AL were significantly higher than those of RCE (P<0.05). The sensitivity of contrast agent leakage to diagnosis of AL was the highest, reaching 96.15% (25/26).ConclusionsThe sensitivity of intra-intestinal angiography CT in the diagnosis of AL is high and the overall diagnostic efficiency is better than RCE, and the leakage of contrast agent is the main imaging feature of AL. It is significant to guide the clinical practice.
ObjectiveTo evaluate the efficacy of western conventional treatment based on traditional Chinese medicine retention enema on patients with hepatic encephalopathy. MethodsSuch databases as the Cochrane Library, PubMed, EMbase, VIP, CNKI, CBM and WanFang Database were searched from the inception to November 2013 to collect randomized controlled trials (RCTs) about Western conventional treatment based on traditional Chinese medicine retention enema to treat hepatic encephalopathy, and the references of the included literature were also retrieved. Two reviewers independently screened the literature according to the inclusion and exclusion criteria, extracted the data, and evaluated and cross-checked the methodological quality. Then meta-analysis was conducted using RevMan 5.1 software. ResultsA total of 26 RCTs involving 1 691 patients were included. The subgroup analyses based on the length of intervention time showed that when the course of treatment intervention was less than one, the overall effective rate of the Chinese herbal retention enema group was higher than that of the control group, with a significant difference[RR=1.34, 95%CI (1.25, 1.44), P<0.000 01]; after more than one course of treatment intervention, the overall effective rate of the Chinese herbal retention enema group was higher than that of the control group, with a significant difference[RR=1.34, 95%CI (1.21, 1.48), P<0.000 01]. ConclusionOn the basis of available evidence, the western medicine treatment based on traditional Chinese medicine retention enema for hepatic encephalopathy has a certain effect. However, the heterogeneity among the included studies is large. It is necessary to design multicenter, strictly randomized and double-blind test controlled trials with large samples to validate these conclusions and to further confirm the clinical curative effect.