注气和注水结肠镜下结直肠息肉的内镜形态特征与病理类型的关系分析  

Relationship between Endoscopic Morphological Characteristics and Pathological Types of Colorectal Polyps under Gas Injection and Water Injection Colonoscopy

作　　者：翟春颖[1] 柯小丽[1] 徐耀华[1] 程晓荷 邱宇 ZHAI Chunying;KE Xiaoli;XU Yaohua;CHENG Xiaohe;QIU Yu(Beijing Puren Hospital,Beijing 100062,China;不详)

机构地区：[1]北京市普仁医院,北京100062

出　　处：《中国医学创新》2023年第2期64-68,共5页Medical Innovation of China

摘　　要：目的:研究注气和注水结肠镜下结直肠息肉的内镜形态特征与病理类型的关系。方法:选择2019年5月-2021年12月北京市普仁医院收治的120例结直肠息肉患者作为研究对象,采用随机数字表法分为注气组(n=60)和注水组(n=60)。注气组予以注气结肠镜检查,注水组予以注水结肠镜检查。统计两组结直肠息肉检出数量,比较两组扁平息肉检出率、肿瘤性息肉检出率。以病理学诊断结果为金标准,评估注水组与注气组中NICE分型对结直肠息肉病变的预测价值。结果:120例患者共检出152枚结直肠息肉,其中注气组检出89枚,注水组检出63枚。两组扁平息肉检出率、左半结肠扁平息肉检出率比较,差异均无统计学意义(P>0.05),注水组右半结肠扁平息肉检出率高于对照组,差异有统计学意义(P<0.05);152枚息肉病理诊断结果中肿瘤性息肉85枚(55.92%)、非肿瘤性息肉67枚(44.08%);注水组与注气组肿瘤性息肉检出率比较,差异无统计学意义(P>0.05);152枚结直肠息肉的NICE分型包括1型62枚、2型86枚、3型4枚,以病理学诊断结果为金标准,NICE分型标准对结直肠息肉病理类型的诊断敏感度为97.65%、特异度为89.55%、准确度为94.08%;注气组与注水组结直肠息肉中NICE分型对结直肠息肉病理病变类型的诊断敏感度、特异度、准确度比较,差异均无统计学意义(P>0.05)。结论:注气和注水结肠镜下结直肠息肉的NICE分型对结直肠息肉肿瘤性和非肿瘤性的鉴别诊断价值相近,两者均可使用NICE分型完成对结直肠息肉病理类型的预测,均有较高的预测价值,但注水结肠镜能有效提高右半结肠扁平息肉的检出率。Objective: To study the relationship between endoscopic morphological characteristics and pathological types of colorectal polyps under gas injection and water injection colonoscopy. Method: A total of 120 patients with colorectal polyps who were admitted to Beijing Puren Hospital from May 2019 to December 2021were selected as the research subjects and divided into gas injection group(n=60) and water injection group(n=60)according to the random number table method. The gas injection group was examined by gas injection colonoscopy,and the water injection group was examined by water injection colonoscopy. The number of colorectal polyps detected in the two groups was counted, and the detection rate of flat polyp and neoplastic polyp were compared between the two groups. Taking pathological diagnosis results as the gold standard, the predictive value of NICE classification in water injection group and gas injection group for colorectal polyps was evaluated. Result: A total of 152 colorectal polyps were detected in 120 patients, 89 were detected in the gas injection group and 63 were detected in the water injection group. There were no significant differences between the two groups in the detection rate of flat polyp and the detection rate of left hemicolonic flat polyp(P>0.05). The detection rate of right hemicolonic flat polyp in the water injection group was higher than that in the control group, the difference was statistically significant(P<0.05).Among the 152 polyps pathologically diagnosed, 85(55.92%) were neoplastic polyps, 67(44.08%) were nonneoplastic polyps. There was no significant difference in the detection rates of neoplastic polyp between the water injection group and the gas injection group(P>0.05). The NICE classification of 152 colorectal polyps included 62 cases of type 1, 86 cases of type 2, and 4 cases of type 3. Taking pathological diagnosis results as the gold standard, the sensitivity, specificity and accuracy of NICE classification criteria in the diagnosis of pathological type of colorectal

关 键 词：注气结肠镜 注水结肠镜 结直肠息肉 内镜形态特征 病理类型 

分 类 号：R574[医药卫生—消化系统]