内镜下钛夹标记联合腹平片检查在消化道微小肿物术前定位中的临床应用  

Clinical research on preoperative localization of gastric and colorectal minor cancer by titanium clip markers with endoscopy and plain abdominal radiograph

作　　者：张海宏[1] 王石林[1] 魏学明[1] 金晓维[1] 

机构地区：[1]中国人民解放军空军总医院普通外科,北京100142

出　　处：《临床外科杂志》2014年第3期182-184,共3页Journal of Clinical Surgery

基　　金：空军总医院创新基金资助（项目编号：kz2013032）

摘　　要：目的 观察消化内窥镜下钛夹标记联合腹平片检查在消化道微小肿物术前定位的应用效果.方法 胃、结直肠微小肿瘤患者21例经消化内窥镜检查发现肿物病灶后,常规活检并瘤体旁放置钛夹,术前16～24h行卧位腹部X线平片检查了解钛夹位置,以便术前确定病灶部位; 并与术中所见肿物实际位置进行比较,从而判断该方法在术前定位的准确率.结果 21例患者消化内窥镜下钛夹标记联合腹部平片定位与手术结果符合率100%（21/21）.结论 对胃、结直肠微小肿物的患者来说,钛夹标记联合腹平片检查是手术前准确可靠的病灶定位方法,对顺利完成胃、结直肠微小肿物手术有现实的临床意义.Objective To study the value of titanium clip markers with endoscopy and plain abdominal radiograph in gastric and colorectal minor cancer preoperative localization. Methods A total of 21 patients with gastric and colorectal minor cancer were chosen to study. All patients were confirmed by surgery and pathology. Titanium clip markers were placed near the cancer lesions during endoscopy in all patients and the location of titanium clip was determined by plain abdominal radiograph 16 -24h before surgery. The localization was compared with surgical observation to determine the accuracy. Results Cancer lesions in all 21 patients of combined localization group matched exactly with surgical observations （100%）, whereas they matched with endoscopy, gastroenterography, and abdominal CT in 15 cases （71.4%）, 16 cases（76.2% ）, and 13 cases （61.9%）respectively. The accuracy between the two groups was significantly different. Conclusion The titanium clip combined with abdominal plain film is accurate in the localization of gastric and colorectal cancer before operation, which provides an important guidance in the choice of surgical incision and approach.

关 键 词：胃肿瘤 结直肠肿瘤 内窥镜 钛夹 

分 类 号：R735[医药卫生—肿瘤]