窄带成像内镜、染色内镜与常规内镜对直肠息肉检出情况的对比研究  

A comparative study of narrow band imaging, chromoendoscopy and conventional imaging for rectum polyps

作　　者：石磊[1] 田晶晶[2] 李红洲[1] 张姝翌[1] 朱京国[1] 李文[1] 

机构地区：[1]天津市南开大学人民医院内镜中心,300100 [2]天津市南开医院消化内科

出　　处：《中华消化内镜杂志》2016年第9期628-631,共4页Chinese Journal of Digestive Endoscopy

摘　　要：目的探讨常规内镜、U型反转、U型反转联合窄带成像内镜（NBI）及染色内镜对直肠息肉的诊断价值。方法临床上收集无麻醉结肠镜检查的患者100例，采用4种方法（常规内镜直视法、U型反转法、U型反转＋NBI内镜法、U型反转＋染色内镜法）对直肠进行观察，分别观察直肠息肉的大小、数量，直肠黏膜受损程度及反转视野，并记录患者疼痛情况等。结果常规内镜直视法、U型反转法、U型反转＋NBI内镜法及U型反转＋染色内镜法分别检测出直肠息肉患者例数为51例（51．00％）、68例（68．00％）、77例（77．00％）、96例（96．00％）。与直视组比较，U型反转组、U型反转＋NBI组、U型反转＋染色组直肠息肉患者检出率明显升高（P〈0．01）；与u型反转组比较，U型反转＋NBI组、U型反转＋染色组检出率升高（P〈0．05）；与U型反转＋NBI组比较，U型反转＋染色组检出率升高（P〈0．05）。其中，检出息肉直径≤0．5cm的患者数分别为43例（84．31％）、59例（86．76％）、68例（88．31％）、86例（89．58％）；息肉直径〉0．5—1．0cm的患者数分别为4例（7．84％）、4例（5．88％）、4例（5．19％）、4例（4．17％）；息肉直径〉1．0em的患者数分别为4例（7．84％）、5例（7．35％）、5例（6．49％）、6例（6．25％），4组间比较差异均无统计学意义（P〉0．05）。结论直肠u型反转安全性高，对患者的痛苦并无明显增加，可提高直肠病变的检出率。另外，在U型反转的基础上，联合NBI内镜及染色内镜可以明显提高息肉的检出率，尤其是直径≤0．5cm的息肉及增生性息肉。Objective To compare the diagnostic value of conventional imaging, U-type reversal mirror method,narrow band imaging, and ehromoendoscopy for rectum polyps. Methods Data of 100 pa- tients who underwent eolonoseopy （conventional imaging, U-type reversal mirror method, narrow band imaging, and chromoendoscopy） were collected to observe the rectum polyps.The size, number, damage de- gree of intestinal mueosa, reversal view and pain degrees were recorded. Results The detection rates of conventional imaging group, U-type reversal mirror group, narrow band imaging group and ehromoendoscopy group were 51.00%, 68.00%, 77.00% and 96. 00% respectively. The detection rate of U-type reversal mir- ror group, narrow band imaging group and ehromoendoscopy group improved significantly compared with that of the conventional imaging group（ P〈0. 01 ） ;The detection rate of narrow band imaging group and chromoen- doscopy group was significantly higher than that of U-type reversal mirror group （P〈0. 05 ） ;The detection rate of ehromoendoseopy group was significantly higher compared with the narrow band imaging group（ P〈0. 05 ）. The detection rates of polyps with diameter smaller than 0. 5 cm were 84. 31%o （43/51 ）, 86.76%0 （59/68）, 88.31% （68/77）, and 89. 58% （86/96） （P〉 0.05 ） ;The detection rates of polyps with diameter of 0. 5- 1.0 cm were 7.84% （ 4/51 ）, 5.88% （ 4/68 ）, 5.19% （ 4/77 ）, and 4. 17% （ 4/96 ） （ P 〉 0.05 ） ; The detection rates of polyps with diameter over 1.0 cm were 7.84% （ 4/51 ）, 7. 35% （ 5/68 ）, 6.49% （ 5/77）,6. 25% （6/96） （P 〉 0. 05）. Conclusion The U-type reversal mirror method is safe with little pain and higher detection rate of rectum polyps. U-type reversal mirror method combined with narrow band imaging or chromoendoscopy during colonoscopy can improve the detection rate of rectum polyps especially for those whose diameter is smaller than 0. 5 cm.

关 键 词：直肠息肉 直肠U型反转 窄带内镜 染色内镜 

分 类 号：R574[医药卫生—消化系统]