超声内镜引导活检术在胃黏膜粗大改变疾病中的诊断价值  

Diagnostic value of endoscopic ultrasonography guided biopsy in large gastric folds

作　　者：邓尚新[1] 汪泳[1] 马强[1] 李斌[1] 魏红梅[1] 王静舞[1] 张方信[1] 

机构地区：[1]中国人民解放军兰州军区兰州总医院消化科,甘肃省兰州市730050

出　　处：《世界华人消化杂志》2014年第32期4960-4963,共4页World Chinese Journal of Digestology

摘　　要：目的:通过分析超声内镜检查(endoscopic ultrasonography,EUS)和EUS引导活检术对胃黏膜粗大改变性疾病的诊断能力,寻找更为可靠的诊断方法.方法:2011-07/2013-12中国人民解放军兰州军区兰州总医院常规内镜检查和活检病理无法确诊的34例胃黏膜粗大改变患者予以EUS检查及EUS引导下活检术,依据最终确诊结果,分析EUS引导活检术确诊率及安全性.结果:29例患者最终获得确诊,EUS引导活检术正确诊断率达75.9%,所有患者均未发生穿孔、大出血等严重的并发症,但深挖活检较易引起出血现象(P<0.05).单纯依据病变超声影像特点,EUS对胃癌的诊断正确率为69.0%,灵敏度63.2%,特异度80.0%;对淋巴瘤诊断正确率为62.1%,灵敏度25.0%,特异度76.2%.结论:EUS引导活检术是胃黏膜粗大改变性疾病较为有效的确诊方法.AIM： To compare the accuracy of endoscopic ultrasonography （EUS） vs EUS-guided biopsy in the diagnosis of large gastric folds. METHODS： Thirty-four patients with suspected large gastric folds who underwent EUS and EUS-guided biopsy from July 2011 to December 2013 were included. The diagnostic accuracy and safety of EUS-guided biopsy were evacu- ated according to the final results. RESULTS： Twenty-nine patients were finally di- agnosed. The overall accuracy rate of EUS-guid- ed biopsy was 75.9%. Severe complications such as perforation and severe bleeding were not seen during and after the process of EUS-guidedbiopsy. Deep biopsy guided by EUS was easier to cause bleeding than large mucosal biopsy （P 〈 0.05）. According to the characteristics of ul- trasound imaging of each lesion, the diagnostic accuracy rate of EUS for gastric cancer was 69%, sensitivity 63.2%, and specificity 80.0%; accuracy 62.1%, sensitivity 25.0%, and specificity 76.2% for lymphoma. CONCLUSION： EUS-guided biopsy is an effec- tive diagnostic method for large gastric folds.

关 键 词：超声内镜引导活检术 胃黏膜皱襞粗大 诊断 

分 类 号：R573[医药卫生—消化系统]