降低大肠肿瘤漏诊率的措施  

New progress in reducing the missed rate of colorectal neoplasm

作　　者：王晟[1] 韩晔[1] 孙思予[1] 

机构地区：[1]中国医科大学附属盛京医院内镜中心,沈阳110021

出　　处：《中国实用内科杂志》2015年第3期187-189,共3页Chinese Journal of Practical Internal Medicine

摘　　要：肠镜被认为是大肠检查的"金标准",但是困扰内镜医生的是在检查过程中存在的漏诊问题。文章总结了目前降低肠镜漏诊率的操作方法,包括肠镜检查时间、肠道清洁程度、操作者的技术水平、透明帽的使用,提高诊断率的诊断技术,包括染色、窄带成像内镜、弹性光谱彩色成像内镜、高清智能电子染色内镜等,以及总结结肠检查的最新内镜设备,包括广角肠镜、反转肠镜、"第三只眼"反转内镜、330°全周肠镜等。希望对肠镜医生的临床工作有所帮助,在最大程度上降低大肠疾病的漏诊。Colonoscopy has long been considered the gold standard for evaluation of the colon. Unfortunately,time has shown that colonoscopy may be a flawed gold standard,as lesions may be missed and carcinomas may not be prevented. In this brief review,we conclude the operation methods to reduce the rate of missed diagnosis of colonoscopy,including the 6-min withdrawal time,proper bowel preparation,experience of the endoscopist,use of a transparent cap. We also summarize novel approaches for improving colorectal neoplasm detection rate,such as chromoendoscopy,narrow band imaging（NBI）,the flexible spectral imaging color enhancement（FICE）,i-scan and so on. New endoscopic instruments,such as wide-angle colonoscope,retroview colonoscope,thirdeye retroscope（TER）,330°full view colonoscope are explored to help clinical work and reduce the missed rate in the largest extent.

关 键 词：肠镜 大肠肿瘤 漏诊 

分 类 号：R735.34[医药卫生—肿瘤]