Four kinds of checks for ulcers nowhere to escape
1, X-ray barium meal examination
Is an important one way. In particular, double contrast barium gas and duodenal hypotonic angiography applications, further enhanced the diagnostic accuracy. X-ray signs of ulcers have a direct and indirect are two kinds of Kan Ying is a symptom of ulcer, gastric ulcer more prominent cavity in the lesser curvature, the anterior and posterior wall ulcers bulb-shaped Kan Ying Chang Cheng Park, increase the density of the barium shadow, surrounded by halo-like light shadow or transparent areas, and sometimes shows signs of folds concentrated. Indirect signs of inflammation around the multi-line ulcers, convulsions, or scarring caused by barium meal examination shows localized deformation, irritability, convulsions and local tender points of notch, indirect signs of specificity is limited, duodenitis or surrounding organs (such as the gallbladder) inflammation, may also cause the above-mentioned indirect signs, clinical identification should pay attention to.
2, endoscopy
Fibers and electronic stomach, duodenum mirror not only clear, direct observation of the stomach, duodenum mucosa changes and ulcer size, shape, can be obtained under direct vision brush cells or pliers to take the Organization for pathological examination. Can make an accurate diagnosis of peptic ulcer and benign differential diagnosis of malignant ulcers, in addition, but also the activities of dynamic observation period and the ulcer healing process. Observe the effects of drug treatment and so on.
Endoscopic ulcers can be divided into three periods: 1, active phase (ActiveStage): ulcer was park or oval-shaped depression, the bottom of the formation, covered white or yellow-white thick fur, edge finishing, the edge congestion and edema was flush ulcer surrounded by However, smooth mucous membrane, inflammation subsided after the visible concentration of the surrounding folds. 2, healing stage (Healingstage): ulcer narrow shallow, congestion and edema around the flush faded, folds concentrated at the bottom of leakage reduction in thin surface of gray moss. 3, scarring period (ScarringStage): the bottom of the thin white moss disappear, ulcers, red for scar healing epithelium, may from time to trace, or left behind after the white scars and folds to focus ulcer showed complete healing, these three can still be divided into A1, A2; H1, H2 and S1, S2 and other subtypes.
3, gastric analysis
Gastric ulcer and gastric acid secretion in patients with normal or slightly lower than normal, duodenal ulcer patients were mostly higher at night and fasting more obvious. The general results of the analysis can not really response to gastric acid secretion capacity of gastric mucosa, are multi-purpose pentagastrin or histamine increased gastric acid secretion test, were determined based acid output (BAO) and the maximum amount of gastric acid and the peak excretion (MAO and PAO). That much has happened on the following diagnostic or reference value: ① to exclude gastrinoma due to peptic ulcer, such as the BAO of more than 15mmol / hour, MAO than 60mmol / hour, or BAO / MAO ratio is greater than 60%, suggesting that gastrin Su tumor diagnosis. ② distinction between benign and malignant gastric ulcer, reference MAO results, such as the Department of authenticity achlorhydria should be highly suspected tumor ulcer. ③ symptoms typical, MAO than 40mmol / hour, suggesting that active duodenal ulcer.
4, fecal occult blood examination
Ulcer in active stage, fecal occult blood test was positive, after active treatment, mostly in 1-2 weeks, overcast.
Pursuant to this chronic disease process, periodically attack and rhythm of a typical upper abdominal pain, performance, often make a preliminary diagnosis. However, the diagnosis of peptic ulcer, especially atypical symptoms who have passed the barium meal X lines and (or) endoscopy can be established.
Comments
Leave a Reply
WordPress ·