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医学美图：消化道造影片之胃篇

2019-06-22 不详 基层医师公社、放射沙龙

消化道造影片胃
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上消化道造影检查是消化道疾病常用的检查方法，是指十二指肠以上部分的消化道造影，上消化道造影检查的部位包括口咽、食管、胃和十二指肠。

上消化道造影检查是消化道疾病常用的检查方法，是指十二指肠以上部分的消化道造影，上消化道造影检查的部位包括口咽、食管、胃和十二指肠。

造影时多吞入造影剂，也就是病人所说的“吞白药水”。

目前最多采用的是钡剂，如硫酸钡，加入阿拉伯胶制成钡胶浆糊剂，有时加上发泡剂进行双重对比，能更清楚显示消化道内微小病变。



适应证
1.消化不良、上腹部不适等症状
2.体重下降
3.上腹部包块
4.上消化道出血
5.消化道部分梗阻
6.食管裂孔疝
7.上消化道术后复查

禁忌证
1. 完全性消化道梗阻
2. 消化道出血急性期
3. 消化道穿孔
4. 患者体质差、难以耐受检查

正常胃黏膜



胃溃疡





胃恶性溃疡



胃部肿瘤



胃底憩室



胃息肉



胃息肉恶变



胃黏膜脱垂



胃扭转



幽门肥厚



胃底平滑肌瘤



胃大部切除（毕Ⅰ式）术后



胃空肠吻合



注意事项
① 检查前12小时禁饮食。

② 检查前应询问受检者24 h内，有无冲突检查，如腹部彩超、CT、MRI检查等，避免行造影后，影响相关检查进程。

③ 如怀疑有胃肠道梗阻、食管-气管瘘、食管-纵隔瘘、食管及胃肠道术后吻合口瘘等，禁止使用钡剂，应用碘剂，如泛影葡胺、碘海醇等。

④ 如幽门梗阻、胃内大量潴留液患者，要求做造影检查时，应提前抽吸胃液。

⑤ 遇行动不便患者，应告知检查流程，争取配合，配合欠佳者，提前告知检查局限性，避免因检查图像未达要求，引起纠纷。

⑥ 应尽量使用产气剂，以达到良好对比效果；使用产气剂时，应干咽产气剂后，服用少量清水（约5~10 ml），切勿用钡剂送服，以至气泡影响检查精确性。

⑦ 钡剂浓度约160%~200%，大约为筷子一半粗细、拉丝不断为宜。

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