计算机断层扫描结肠造影检查在结直肠肿瘤术前诊断中的应用价值  

Application value of computed tomography colonography examination in preoperative diagnosis of colorectal tumors

作　　者：王雪萍 张海三[1] WANG Xue-ping;ZHANG Hai-san(the Second Affiliated Hospital of Xinxiang Medical University,Xinxiang 453000;Henan Cancer Hospital,Zhengzhou 450000,China)

机构地区：[1]河南省新乡市新乡医学院第二附属医院,河南新乡453000 [2]河南省肿瘤医院,河南郑州450000

出　　处：《临床医学研究与实践》2020年第21期114-117,共4页Clinical Research and Practice

摘　　要：目的探讨计算机断层扫描结肠造影(CTC)检查在结直肠肿瘤术前诊断中的应用价值。方法选取2017年1月至2019年12月在河南省肿瘤医院住院的98例结直肠癌患者作为研究对象。患者均行结肠镜检查和CTC检查,并对肿瘤和整个结肠进行评估。比较两种方法的检测结果。结果50例(51.0%)患者未完成结肠镜检查,主要是因为阻塞或肿块造成肠道闭塞。88例(89.8%)患者完成CTC检查,且可观察整个结肠;10例(10.2%)患者由于肠道扩张不充分未完成CTC检查,原因是屏气困难或肿瘤引起的闭塞,而采用其他方法确定诊断。结肠镜检查盲肠、升结肠部位肿瘤的检出率明显小于CTC检查(P<0.05)。结肠镜检查能够估计肿瘤大小者32例(66.7%),CTC检查中88例(100.0%)均可测量肿瘤大小。结肠镜检查的肿瘤大小与手术标本测量结果比较,差异具有统计学意义(P<0.05);CTC检查肿瘤大小与手术标本测量结果比较,差异无统计学意义(P>0.05)。CTC检查的肿瘤形态学特征与结肠镜检查结果基本一致。结肠镜检查判断有肠道及周围组织浸润22例(45.8%),明显少于CTC检查判断的58例(65.9%)(P<0.05)。结论CTC检查是诊断结直肠肿瘤的一种有效方法,其可帮助临床医生观测诊断肿瘤,确定局部肿瘤的进展,并检测大肠的同步病变,包括内窥镜检查不到的区域。Objective To explore the application value of computed tomography colonography(CTC)examination in preoperative diagnosis of colorectal tumors.Methods A total of 98 patients with colorectal cancer who were hospitalized in Henan cancer hospital from January 2017 to December 2019 were selected as the research objects.All patients underwent colonoscopy and CTC examination,and the tumor and the whole colon were evaluated.The test results of the two methods were compared.Results Fifty patients(51.0%)did not complete colonoscopy examination,mainly due to intestinal obstruction caused by obstruction or mass.A total of 88 patients(89.8%)completed CTC examination and could observe the whole colon;10 patients(10.2%)did not complete the CTC examination due to inadequate intestinal distention,the cause was difficulty in breath holding or tumor induced occlusion,and other methods were used to determine the diagnosis.The detection rates of tumors in cecum and ascending colon by colonoscopy examination were significantly lower than those by CTC examination(P<0.05).Colonoscopy examination could estimate the tumor size in 32 cases(66.7%),and 88 cases(100.0%)could measure the tumor size in CTC examination.There were statistically significant differences in tumor size between colonoscopy examination and surgical specimens measure result(P<0.05);there were no statistically significant differences in tumor size between CTC examination and surgical specimens measure result(P>0.05).The morphologic features of the tumors examined by CTC examination were basically consistent with the results of colonoscopy examination.A total of 22 cases(45.8%)had intestinal and peripheral tissue infiltration by colonoscopy examination,which was significantly less than that of 58 cases(65.9%)by CTC examination(P<0.05).Conclusion CTC examination is an effective method for the diagnosis of colorectal tumors.It can help clinicians observe and diagnose tumors,determine the progress of local tumors,and detect synchronous lesions of the large intestine,includin

关 键 词：计算机断层扫描结肠造影 结肠镜 结直肠肿瘤 

分 类 号：R735.5[医药卫生—肿瘤]