Diabetik gastroparezinin tanisinda ultrasonografinin yeri
Ultrasonography in diagnosis of diabetic gastroparesis
Özet
Giris ve amaç: Diabetik gastroparezi diabetli hastalarin yaklasik yari- sinda görülmektedir. Tanida altin standart olan yöntem sintigrafidir. Ancak daha kolay ve uygulanabilir bir yöntem olan ultrasonografinin tani- daki yerini farkli bir metodla arastirmak istedik. Gereç ve yöntem: Dicle Üniversitesi Tip Fakültesi Iç Hastaliklari Kliniginde takip edilen 30 hasta ile ayaktan 30 saglikli birey kontrol grubu olarak çalismaya alindi. Hasta grubundakilerin 19’u (%63) kadin, 11’i (%37) erkekti. Yas ortalamalari 42.6±11.49 idi. Kontrol grubunun ise 18’i (%60) kadin, 12’si (%40) erkekti. Ortalama yas 42.9±11.06 idi. Hastalarin test yemegi verildikten 15 ve 90 dakika sonra antral alan ölçümler yapildi. Birinci ölçümden ikinci ölçüme kadar geçen süreçte antral alanda meydana gelen küçülmenin yüzde degeri gastrik bosalma orani (Gastric emptying rate =GER) olarak kabul edildi. Bulgular: Hastalarin 15. ve 90. dakika antral alan ölçümlerinin ortalamasi sirasiyla 995,6±26 mm2 ve 592,1±258,81 mm2 olarak bulundu. Saglikli kontrol grubundaki bireylerin 15. ve 90. dakika antral alan ölçümlerinin ortalamasi da sirasiyla 1034,3±237,7 mm2 ve 337,2± 118,7 mm2 seklindeydi. Hasta ve kontrol grubunun 90.dk GER degerleri ortalamasi sirasiyla %41±16 ve %63±9 olarak bulundu. Her iki grubun 15. dakika antral alan ölçüm degerleri arasinda istatistiksel fark saptanmamasina karsin (p>0.05), 90. dakika ölçümleri arasinda istatistiksel olarak anlamli fark saptandi (p<0.0001). Yine, 90.dakika GER degerleri bakimindan da her iki grup arasinda istatistiksel olarak anlamli fark bulundu (p<0.0001). Sonuç: Çalismamizda uygulanan bu pratik yöntemle de gastroparezi tanisinin konulabildigi görülmüstür.
Abstract
Background and aims: Diabetic gastroparesis is seen in approximately half of the diabetic patients. The gold standard technique in diagnosis is scintigraphy. We wanted to diagnose diabetic gastroparesis by ultrasonography, an easier, more practical method. In the present study, a different ultrasonographic technique was used. Material and methods: 30 patients from the Department of Internal Medicine of Dicle University Hospital and 30 healthy individuals as a control group were included in the study. Nineteen (63%) of the patient group were female; 11 (37%) were male. Mean age was 42.6±11.49. Eighteen (60%) of the control group were female; 12 (40%) were male. Mean age was 42.9±11.06. Fifteen and 90 minutes after the test meal, antral area of the patients was measured. The percentage of the decreased volume between the first and second measurements was taken as gastric emptying rate (GER). Results: Patients’ 15th and 90th minute mean antral areas were found as 995,6±26 mm2 and 592,12±258,8 mm2, respectively. Fifteenth and 90th minute mean antral area measurements of the healthy control groupwere 1034,3±237,7 mm2 and 337,2764± 118,7083 mm2, respectively. Although the difference in 15th minute antral area measurements between the groups was statistically insignificant (p>0.05), differences in 90th minute measurements were statistically significant (p<0.0001). Difference in 90th minute GER measurements was found statistically significant between the groups (p<0.0001). Conclusion: In our study, it was demonstrated that gastroparesis could be diagnosed with this practical method.
