각기 다른 유문-십이지장의 기질적 병변 3증례에 대한 장음 측정 보고 : 장음의 주주파수를 중심으로
Bowel Sound Recording for Structural Deformity in the Pylorus-Duodenum: Report of 3 Cases
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참고문헌
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초록
Objectives: The purpose of this study is to report bowel sound patterns recorded in 3 diseases associated with structural deformity of the pylorus-duodenum. Methods: Bowel sound recording is a useful non-invasive tool for the evaluation of gastrointestinal motility. However, the difficulty in manual attachment of the electronic stethoscope on the abdominal wall and noise production against bowel sound signals have prohibited its widespread use. Therefore, I developed a new apparatus that eliminates the noise; it contains a sound absorbing device and a holder for the head of stethoscope. Using the new bowel sound recording system, bowel sounds of the patients were recorded repeatedly. The endoscopic and abdominal computed tomography findings were obtained from other hospitals’ medical record, and all patients were confirmed to have structural deformity in the pylorus-duodenum. The records of each patient were compared and assessed. Results: Patients had either duodenal ulcer scar, pyloric stricture, or far advanced malignant stomach cancer, as diagnosed by the gastroscopy. Their dominant frequency of bowel sound obtained from the new system was checked more than 2 times at regular intervals. All 8 recordings in the 2 patients with duodenal ulcer scar (5 times) or pyloric stricture (3 times) showed a decrease in postprandial than fasting dominant frequency. One patient with stomach cancer showed no significant change between postprandial and fasting states at 2 recordings. Conclusions: The analysis of dominant frequency in bowel sounds can indicate the existence of pyloric obstruction that could delay gastric emptying.
Abstract
Objectives: The purpose of this study is to report bowel sound patterns recorded in 3 diseases associated with structural deformity of the pylorus-duodenum. Methods: Bowel sound recording is a useful non-invasive tool for the evaluation of gastrointestinal motility. However, the difficulty in manual attachment of the electronic stethoscope on the abdominal wall and noise production against bowel sound signals have prohibited its widespread use. Therefore, I developed a new apparatus that eliminates the noise; it contains a sound absorbing device and a holder for the head of stethoscope. Using the new bowel sound recording system, bowel sounds of the patients were recorded repeatedly. The endoscopic and abdominal computed tomography findings were obtained from other hospitals’ medical record, and all patients were confirmed to have structural deformity in the pylorus-duodenum. The records of each patient were compared and assessed. Results: Patients had either duodenal ulcer scar, pyloric stricture, or far advanced malignant stomach cancer, as diagnosed by the gastroscopy. Their dominant frequency of bowel sound obtained from the new system was checked more than 2 times at regular intervals. All 8 recordings in the 2 patients with duodenal ulcer scar (5 times) or pyloric stricture (3 times) showed a decrease in postprandial than fasting dominant frequency. One patient with stomach cancer showed no significant change between postprandial and fasting states at 2 recordings. Conclusions: The analysis of dominant frequency in bowel sounds can indicate the existence of pyloric obstruction that could delay gastric emptying.
참고문헌 (23)
- Farrar JT, "Gastrointestinal Motility As Revealed By Study Of Abdominal Sound", Gastroenterology, 29(5), pp.789~800 (1955)
- Cullen PT1, "Detection of clustered gastrointestinal contractions in partial intestinal obstruction by surface vibration analysis", Ann Surg, 210(2), pp.234~238 (1989)
- Craine BL1, "Enterotachogram analysis to distinguish irritable bowel syndrome from Crohn's disease", Dig Dis Sci, 46(9), pp.1974~1979 (2001)
- 김소연, "한방치료가 위 미주신경 활성 저하와 유문부 기능 장애가 병발된 기능성 소화불량증 환자에 미치는 선택적 효능", 대한한방내과학회지, 30(1), pp.191~199 (2009), 대한한방내과학회
- 김유승, "기능성 소화불량증 환자의 위 미주신경 활성 및 유문부 기능에 대한 足三里 전침과 일반 체침 자극의 복합 효능", 대한한방내과학회지, 29(3), pp.621~628 (2008), 대한한방내과학회
- Yuki M, "Is a computerized bowel sound auscultation system useful for the detection of increased bowel motility?", Am J Gastroenterol, 97(7), pp.1846~1848 (2002)
- Gu C1, "Temporal and spatial relationship of pylorus to antroduodenal motility in functional dyspepsia", Chin Med J (Engl), 111(10), pp.906~909 (1998)
- 홍인아, "기능성 소화불량증 환자의 위장관 부교감 신경, 위 유문부의 기능 및 임상양상에 대한 조사 (한방병원 내원 환자를 중심으로)", 대한한방내과학회지, 29(3), pp.666~674 (2008), 대한한방내과학회
- Watson WC, "Phonoenterography: the recording and analysis of bowel sounds", Gut, 8(1), pp.88~94 (1967)
- Yamaguchi K, "Evaluation of gastrointestinal motility by computerized analysis of abdominal auscultation findings", J Gastroenterol Hepatol, 21(3), pp.510~514 (2006)
- Politzer JP, "The genesis of bowel sounds;influence of viscus and gastrointestinal content", Gastroenterology, 71(2), pp.282~285 (1976)
- Tomomasa T, "Gastrointestinal Sounds and Migrating Motor Complex in Fasted Humans", Am J Gastroenterol, 94(2), pp.374~381 (1999)
- Dalle D, "Computer analysis of bowel sounds", J Comput Biol Med, 4(3), pp.247~256 (1975)
- Arnbjornsson E, "Normal and pathological bowel sound patterns", Ann Chir Gynaecol, 75(6), pp.314~318 (1986)
- King PM, "Relationships of human antroduodenal motility and transpyloric fluid movement:non-invasive observations with real-time ultrasound", Gut, 25(12), pp.1384~1391 (1984)
- 윤상협, "機能性 消化不良症 患者의 食後 心下？滿과 pyloric valve의 機能障碍 - 장음과 위전도를 중심으로", 대한한방내과학회지, 28(4), pp.769~778 (2007), 대한한방내과학회
- Tomomasa T, "Gastrointestinal sounds and migrating motor complex in fasted humans", Am J Gastroenterol, 94(2), pp.374~381 (1999)
- Yamanaka H, "Two cases of pyloduodenal stenosis: the efficiency of gastric emptying evaluation using 13C continuous breath test (BreathID System)", Digestion, 74(3), pp.238~ (2006)
- Tahara T, "Association of endoscopic appearances with dyspeptic symptoms", J Gastroenterol, 43(3), pp.208~215 (2008)
- Tomomasa T, "Analysis of gastrointestinal sounds in infants with pyloric stenosis before and after pyloromyotomy", Pediatrics, 104(5), pp.e60~ (1999)
- Malbert CH, "Vagal control of transpyloric flow and pyloric resistance", Dig Dis Sci, 39(12 Suppl), pp.24S~27S (1994)
- "의료기기의 안정성시험 기준[제2013-72호", 식품의약품안전처, ~ (2013)
- 차재훈, "양도락의 반복성, 재현성에 관한 임상적 연구", 대한한의학회지, 30(1), pp.76~82 (2009), 대한한의학회