窄带成像技术对胃黏膜高级别上皮内瘤变患者临床疗效的影响  

Effect of narrow band imaging on the clinical efficacy of high grade gastric mucosal epithelial neoplasia

作　　者：李庆芝[1] 庄天彦[1] Qing-zhi Li;Tian-yan Zhuang(Department of Gastroenterology, Heze Municipal Hospital, Heze, Shandong 274031, China)

机构地区：[1]山东省菏泽市立医院消化内科,山东菏泽274031

出　　处：《中国内镜杂志》2017年第3期74-78,共5页China Journal of Endoscopy

摘　　要：目的探究窄带成像技术(NBI)对胃黏膜高级别上皮内瘤变(HGIN)患者临床疗效的影响。方法选取2006年6月-2016年6月该院接收治疗的96例胃黏膜HGIN患者为研究对象,采用随机数表法将患者分为对照组和观察组,各48例。对照组患者采用内镜黏膜下剥离术(ESD)治疗,观察组患者采用NBI联合ESD治疗。比较两组患者的各项手术情况、术后病理分型和并发症发生情况。结果观察组患者的手术时间、切缘阳性率均低于对照组,病灶直径、一次性整块切除率和治愈性切除率均高于对照组,差异具有统计学意义(P<0.05)。观察组术后病理分型包括27例HGIN癌变患者,15例HGIN伴局灶癌变患者和6例高-中分化腺癌患者,对照组术后病理分型包括1例低级别上皮内瘤变(LGIN)患者,33例HGIN癌变患者,11例HGIN伴局灶癌变患者和3例高-中分化腺癌患者,差异无统计学意义(P>0.05)。观察组与对照组患者的并发症总发生率分别为6.25%和22.92%,观察组明显低于对照组,差异具有统计学意义(P<0.05)。结论采用NBI联合内镜治疗胃黏膜HGIN患者能够显著提高病灶的整块完整切除率和治愈性切除率,缩短手术时间,降低并发症发生率。Objective To explore the effect of narrow band imaging on the clinical outcomes of patients withhigh grade intraepithelial neoplasia in gastric mucosa.Methods From June2006to June2016,96patients of gastrichigh-grade intraepithelial neoplasia were enrolled in the study.All patients were divided into control group andobservation group using a random number table method,48cases in each.In control group,patients were treatedwith endoscopic submucosal dissection treatment,while in observation group,patients were treated with narrowbandimaging combined with endoscopic submucosal dissection treatment.The operation time,pathological type andoccurrence of complications of the two groups were compared.Results The operation time,positive margin rates inobservation group were lower than that in control group,while tumor diameter,one en bloc resection rate and curativeresection rate was higher,the difference was statistically significant(P<0.05).Pathological type:observation groupincludes27cases of HGIN,15cases of focal HGIN and6cases of high-moderately differentiated adenocarcinoma;while in control group,including1case of LGIN,33cases of HGIN,11cases of focal HGIN and3cases of highdifferentiatedadenocarcinoma patients,the difference was not statistically significant(P>0.05).Overall incidence of complications in observation group and control group were6.25%and22.92%respectively;which shown observationgroup has significantly lower rate than control group,the difference was statistically.Conclusion Narrow-bandimaging combined with endoscopy in the treatment of gastric neoplasia in patients with high-grade intraepitheliallesions can significantly improve the cure rate and complete resection en bloc resection rate,shorten the operationtime,reduce the incidence of complications.

关 键 词：窄带成像技术 内镜黏膜下剥离术 高级别 胃黏膜上皮内瘤变 

分 类 号：R735.2[医药卫生—肿瘤]