細径超音波プローブによる十二指腸潰瘍の検討―ゼリー注入法の応用― A STUDY ON DUODENAL ULCERS BY ULTRASONIC PROBE: APPLICATION OF JELLY INFUSION METHOD

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Abstract

細径超音波プローブによる十二指腸潰瘍の観察のために,ゼリー注入法を考案し,67例100病変を対象にその有用性を検討した.その結果,前壁潰瘍の描出率は,52/65病変80%と比較的良好な描出率であったのに比べ,後壁潰瘍の描出率は11/35病変31%と不良であった.また,単発潰瘍の描出率は,29/34病変85%と良好であったが,多発潰瘍では34/66病変52%と不良であり,全体としては100病変中63病変63%が描出可能であった.UH-IV潰瘍の腸管外側潰瘍エコーは,治癒期の7病変70%,瘢痕期の32病変89%には認められなかった.潰瘍の深さ別頻度は,U1-II病変2%,U1-III19病変30%,U1-IV43病変68%であった.S1stageの内視鏡所見のうち,ひだの本数,中心陥凹,辺縁隆起,変形の程度,いずれの所見も,潰瘍の深さをよく反映していた.潰瘍の深さ別累積治癒率は,いずれの時期においてもU1-IIIの治癒率はU1-IVに比較し良好で,全体として両者間に有意差を認めた.また,12週間のH2受容体拮抗剤投与にても治癒しない潰瘍は,すべてU1-IVであった.

We developed a jelly infusion method enabling the evaluation of the duodenal ulcer. From February 1992 to April 1993, ultrasonic probe (USP) were performed in 100 lesions of duodenal ulcer (32 single anterior ulcers, 2 single posterior ulcers, 66 multiple ulcers) using this method. The following conclusions were obtained ; Detection rates of duodenal ulcers were 80% in anterior ulcers, 31% in posterior ulcers, 85% in single ulcers and 52% in multiple ulcers, respectivelly. Extraluminal ulcer echos of U1-IV duodenal ulcers were detected in 3/10 lesions (30%) at healing stage and in 32/36 lesions (11%) at scar stage using USP. Regarding the depth of duodenal ulcers diagnosed by USP the ulcers consist of 2% of U1-II, 30% of U1-III and 68% of U1-IV, respectivelly. Number of folds, central depression, surrounding protrusion and deformity in endoscopic findings at S1 stage reflected the depth of ulcer evaluated by USP. The accumulative healing rate of U1-III ulcers was better than that of U1-IV for all term. Thus, we conclude that USP with the jelly infusion method was useful in follow-up of duodenal ulcer.

Journal

  • GASTROENTEROLOGICAL ENDOSCOPY

    GASTROENTEROLOGICAL ENDOSCOPY 36(3), 499-508_1, 1994

    Japan Gastroenterological Endoscopy Society

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