大肠平坦型病变的内镜下检出情况分析  

Analysis of Endoscopic Detection of Flat Lesions of Large Intestine

作　　者：许国彩[1] 刘芝兰[1] Xu Guocai;Liu Zhilan(Department of Digestive Medicine,Qinghai People's Hospital,Xining 810002)

机构地区：[1]青海省人民医院消化科,西宁810002

出　　处：《数理医药学杂志》2020年第12期1744-1747,共4页Journal of Mathematical Medicine

基　　金：青海省卫健委2018年指导项目,项目编号:2018-wjzdx-29。

摘　　要：目的:探讨不同内镜方法对于大肠平坦型病变的镜下检出情况、病变大小以及组织病理的特点。方法:选取2017年3月~2020年3月来某院内镜中心行结肠镜检查的6392例患者,所有患者均在普通白光模式插镜至回盲部后,分别采用白光、NBI、染色内镜(CE)退镜观察;发现平坦型病变后,观察并记录轮廓、大小、形态和表面微结构等,根据工藤pit pattern内镜分型判定病变,同时行活检,比较白光、NBI、CE联合放大内镜检查的判定结果与病理结果,以及病变大小与病理类型的相关性。结果:共检出大肠平坦型病变患者共120例,检出平坦型病变共132个。其中,白光、NBI、CE分别检出41、36、43名患者,大肠平坦型病变分别为43处、40处、49处,检出患者的男女性别比为1.55∶1,年龄构成比以51~70岁为主。白光、NBI和CE检出的平坦型病变的平均直径分别为(17.3±8.1)mm、(13.7±7.3)mm、(9.9±7.4)mm,对于病变诊断的灵敏度分别为83.33%、92.59%和90.90%,特异度分别为46.15%、76.92%和75%;准确度分别为72.09%、87.50%和85.71%。132处平坦型病变的组织类型以腺瘤为主。结论:对于直径小于1cm的平坦型病变的检出,CE优于普通白光及NBI,而对于平坦型病变组织类型的判断NBI或CE联合放大内镜均优于普通白光内镜联合放大内镜,而且平坦型病变的组织病理类型跟其大小有一定的相关性。Objective:To investigate the microscopic detection,size and histopathological features of different endoscopic methods in patients with flat lesions of large intestine.Methods:6392 patients in a hospital for colonoscopy from March 2017 to March 2020 were selected.The endoscope was first inserted to ileocecal junction in routine white light mode and the observation was made in white light,NBI and CE mode.The contour,size,morphology and surface microstructure were observed and recorded after the flat lesions were found.The pathological changes were determined according to pit pattern endoscopic classification of Kuteng,and the biopsy was performed at the same time.The results of white light,NBI,and CE combined with magnifying endoscopy were compared with pathological results,and the correlation between lesion size and pathological type was compared.Results:A total of 120 patients with flat colorectal lesions and 132 flat lesions were detected.Among them,41,36 and 43 patients were detected by white light,NBI,CE,and there were 43,40 and 49 flat colorectal lesions,respectively.The gender ratio was 1.55∶1,and the age composition ratio was 51~70 years old.The average diameter of flat lesions detected by white light,NBI and CE was(17.3±8.1)mm,(13.7±7.3)mm,and(9.9±7.4)mm,respectively.The sensitivity for diagnosis of lesions was 83.33%,92.59%and 90.90%,the specificity was 46.15%,76.92%and 75%,respectively,and the accuracy was 72.09%,87.50%and 85.71%,respectively.The histological types of the 132 flat lesions were mainly adenomas.Conclusion:For the detection of flat lesions with diameter less than 1cm,CE is superior to ordinary white light and NBI,while for the determination of tissue type of flat lesions,NBI or CE combined magnifying endoscopy are superior to white light combined magnifying endoscopy,and the histopathological type of flat lesions has a certain correlation with its size.

关 键 词：普通白光内镜 窄带成像内镜 色素内镜 大肠平坦型病变 

分 类 号：R574.6[医药卫生—消化系统]