内镜下冰醋酸联合靛胭脂染色对胃黏膜病变的诊断价值  

Clinical application value of acetic acid and indigo carmine staining under endoscope in the auxiliary diagnosis of gastric mucosal disease

作　　者：马颖才[1] 刘芝兰[1] 熊元治[1] 丹珠永吉[1] 马丽莉[1] 王燕[1] 德吉措姆[1] 吉方正[1] 张梦岚[1] 

机构地区：[1]青海省人民医院消化内科,西宁810007

出　　处：《重庆医学》2015年第18期2491-2492,2495,共3页Chongqing medicine

基　　金：卫生部资金资助项目(200902002-3)

摘　　要：目的探讨内镜下冰醋酸联合靛胭脂染色对胃黏膜病变的诊断价值。方法选择常规内镜下发现胃黏膜异常的患者396例,随机分为对照组和冰醋酸联合靛胭脂染色组(染色组),每组198例。对照组普通内镜观察判断病灶并活检,染色组采取染色观察后活检,对比两组一般情况、镜下表现、活检病理等。结果染色组早期胃癌18例(9.1%),高级别上皮内瘤变11例(5.6%),低级别上皮内瘤变16例(8.1%),肠上皮化生51例(25.8%);对照组分别为2例(1.0%)、4例(2.0%)、6例(3.0%)、41例(20.7%)。染色组对早期胃癌、高级别上皮内瘤变、低级别上皮内瘤变、肠上皮化生的检出率高于对照组(P<0.05);染色组检出早期胃癌和高级别上皮内瘤变隆起型3例(1.0%),表浅型16例(55.2%),凹陷型10例(34.5%),三者中表浅型病变检出率高于其他两类(P<0.05)。结论冰醋酸联合靛胭脂染色可指导靶向活检,提高早期胃癌及癌前病变等的检出率,同时有助于判断病变范围和深度。Objective To evaluate the clinical value of acetic acid and indigo carmine staining under endoscope in the auxiliary diagnosis of gastric mucosal disease .Methods After conventional electronic endoscopic diagnosis ,396 patients with gastric mucosal disease were randomly and evenly divided into 2 groups .The staining group was directly sprayed with acetic acid and indigo car‐mine ,the control group was not stained .Comparison of the endoscopic characteristics and the biopsy results between the two groups was made .Results In the staining group ,18 early gastric cancer （9 .1% ） ,11 high‐grade intraepithelial neoplasia （5 .6% ） ,16 low‐grade intraepithelial neoplasia （8 .1% ） and 51 intestinal metaplasia （25 .8） were found ,while in the control group 2 ,early gastric cancers （1 .0% ） ,4 high‐grade intraepithelial neoplasia （2 .0% ） ,6 low‐grade intraepithelial neoplasia （3 .0% ） and 41 intestinal met‐aplasia （20 .7% ） were found respectively .The detection rate of early gastric cancer ,high‐grade intraepithelial neoplasia ,low‐grade intraepithelial neoplasia and intestinal metaplasia in the staining group was higher than that in the control group （P〈0 .05） .In the staining group ,3 early gastric cancer with high‐grade intraepithelial neoplasia protruded type （1 .0% ） ,16 superficial type （55 .2% ） ,and 10 depressed type （34 .5% ） were detected ,among which the detection rate of superficial type was higher than that of the other two types （P〈0 .05） .Conclusion Staining with acetic acid and indigo carmine helps with the targeted biopsy ,improves the detection rates of early gastric cancer and precancerous lesion ,and allow s to estimate the severity of the disease .

关 键 词：胃肿瘤 内镜 醋酸 靛蓝二磺酸钠 

分 类 号：R735.2[医药卫生—肿瘤]