中国实用外科杂志

中国实用外科杂志 ›› 2025, Vol. 45 ›› Issue (04): 465-468.DOI: 10.19538/j.cjps.issn1005-2208.2025.04.15

• 论著 • 上一篇    下一篇

应用食管胃结合部充盈超声造影对食管裂孔疝诊断和术后随访价值研究

马    宁1，蒋清凌2，刘广健2，周太成1，刘创雄1，陈    双1   

  1. 1中山大学附属第六医院普通外科（疝和腹壁外科）  广东省结直肠盆底疾病研究重点实验室  广州市黄埔区中六生物医学创新研院，广东广州 510655；2中山大学附属第六医院超声科，广东广州 510655
  • 出版日期:2025-04-01 发布日期:2025-04-30

  • Online:2025-04-01 Published:2025-04-30

摘要： 目的    探讨食管胃结合部充盈超声造影在食管裂孔疝诊断及术后随访中的应用价值。方法    回顾性分析2022年8月至2023年8月中山大学附属第六医院疝和腹壁外科收治的行腹腔镜食管裂孔疝修补及胃底折叠手术治疗的68例食管裂孔疝病人的临床资料。根据是否行食管胃结合部充盈超声造影分为造影组（35例）和常规组（33例），分析比较两组诊断、治疗及随访相关指标。结果    造影组中，充盈超声造影检查诊断食管裂孔疝阳性率最高，为100%；常规组中，胃镜诊断阳性率最高，为75.8%。两组病人在折叠方式、手术时间、住院时间、术后并发症发生率、胃食管反流病症状缓解率、疗效满意度的差异均无统计学意义 （均P>0.05）。造影组和常规组随访时间分别为10.5（2~17）、8.9（1.6~14.8）个月，造影组病人随访满意度高于常规组（82.8% vs. 48.5%， P＜0.05）。结论    在食管裂孔疝相关检查中，食管胃结合部充盈超声造影具有快速准确、无创及依从性好的优势，值得在人群筛查及术后随访中推广应用。

关键词: 充盈超声造影, 食管裂孔疝, 食管胃结合部, 诊断, 随访

Abstract: Exploring the application of contrast-enhanced ultrasound in the diagnosis and postoperative follow-up of esophageal hiatal hernia. Methods    Retrospective analysis of clinical data of 68 patients with esophageal hiatal hernia who underwent laparoscopic repair and gastric fundus folding surgery in the Department of Hernia and Abdominal Wall Surgery at the Sixth Affiliated Hospital of Sun Yat-sen University from August 2022 to August 2023. According to whether filling ultrasound contrast was performed, patients were divided into a contrast group (35 cases) and a control group (33 cases). The positive diagnosis rate of esophageal hiatal hernia, GERD symptom relief rate, postoperative complications, satisfaction with therapeutic effect, and satisfaction with follow-up were analyzed and compared between the two groups. Results    The highest positive rate for diagnosing esophageal hiatal hernia in the contrast-enhanced ultrasound examination group was 100%, while the highest positive rate for gastroscopy diagnosis in the conventional group was 75.8%. There was no statistically significant difference between the two groups of patients in terms of folding method, surgical time, hospital stay, postoperative complications, GERD symptom relief rate, efficacy satisfaction, and postoperative complications (all P>0.05). The average follow-up time for the imaging group and the conventional group was 10.5 months and 8.9 months, respectively. The satisfaction with follow-up was higher in the imaging group than in the conventional group (82.8% vs. 48.5%, P<0.05). Conclusion    Esophageal gastric junction filling contrast-enhanced ultrasound has the advantages of fast, accurate, non-invasive, and good compliance in the diagnosis and postoperative follow-up evaluation of esophageal hiatal hernia. It is worth promoting and applying in the screening of esophageal hiatal hernia populations and postoperative follow-up.

Key words: filling contrast-enhanced ultrasound, hiatal hernia, the junction of esophagus and stomach, diagnosis, follow-up