常规内镜、NBI电子染色放大内镜及内镜下色素染色对早期大肠肿瘤性病变诊断的研究  

Study on diagnosis of early colorectal neoplastic lesions by conventional endoscopy,NBI electron staining magnifying endoscopy and endoscopic pigment staining

作　　者：姜菊英 张玉华 Jiang Juying;Zhang Yuhua(Department of Gastroenterology,the People's Hospital of Zigui County,Hubei Yichang 443600;Hospital Office,the People's Hospital of Zigui County,Hubei Yichang 443600)

机构地区：[1]秭归县人民医院消化内科,湖北宜昌443600 [2]秭归县人民医院院办公室,湖北宜昌443600

出　　处：《中国社区医师》2020年第16期107-108,共2页Chinese Community Doctors

摘　　要：目的:对比早期大肠肿瘤性病变患者采用内镜常规模式、窄带成像(NBI)模式及色素染色诊断的效果。方法:选取2017年8月-2019年8月结肠镜检查患者400例,均采用内镜进行检查,常规内镜模式下观察腺管开口,NBI内镜模式再次观察开口类型及血管形态,色素染色采用活检孔喷0.2%的靛胭脂,病灶染色后进行观察。三种模式观察时均记录病变情况、腺管开口类型、毛细血管形态。将病变标本进行病理学检查。对比常规模式和NBI模式的病变发现情况,常规模式、NBI模式和色素染色三种方式与病理结果对比,分析内镜诊断的符合率、灵敏度、特异性。对NBI模式和色素染色的检查时间进行对比。结果:常规内镜漏诊率高于NBI模式,以漏诊平坦型为主。NBI模式和色素染色诊断符合率比较,差异无统计学意义(P>0.05);但NBI模式和色素染色比常规模式符合率、灵敏度及特异度高,差异有统计学意义(P<0.05)。NBI模式内镜操作时间显著短于色素染色,差异有统计学意义(P<0.05)。结论:对早期大肠肿瘤性病变进行诊断,内镜检查NBI模式和色素染色效果优于常规模式,诊断准确率更高。Objective:To compare the effect of using conventional endoscopy,NBI electron staining magnifying endoscopy and endoscopic pigment staining for early colorectal neoplastic lesions.Methods:From August 2017 to August 2019,400 patients who examined by colonoscopy were enrolled,all of them were examined by endoscopy and observed by narrowband imaging(NBI)mode and conventional mode.Observed lesions in NBI mode,switched conventional mode to re-observation,conventional mode found lesions,recorded tumor conditions,morphological size.The microvascular morphology was observed to make a typing diagnosis,the time of observation was recorded,the opening condition of glandular tube on the surface of lesion was observed after staining and pathological examination was taken after multi-point biopsy.The diagnostic results of conventional endoscopy,NBI endoscopy and endoscopic pigment staining was compared.Results:The rate of missed diagnosis of conventional endoscopy was higher than NBI endoscopy,the flat type of missed diagnosis was the main one.The diagnostic coincidence rates between NBI endoscopy and staining magnifying endoscopy was compared,the difference was not statistically significant(P>0.05).But NBI endoscopy and staining magnifying endoscopy were more sensitive and specific than conventional endoscopy and the coincidence rates was higher,the differences were statistically significant(P<0.05).The endoscopic operation time of NBI was significantly shorter than endoscopic pigment staining,the difference was statistically significant(P<0.05).Conclusion:For the diagnosis of early colorectal neoplastic lesions,NBI endoscopy and endoscopic pigment staining are better than conventional endoscopy and the diagnostic accuracy is higher.

关 键 词：大肠肿瘤性病变 早癌诊断 窄带成像 色素染色 

分 类 号：R735.34[医药卫生—肿瘤]