【摘要】 目的探讨窄带成像结合放大内镜在胃黏膜平坦型病变诊断中的临床应用价值。方法常规内镜检查的患者中发现有胃黏膜平坦型病变者入组,共120例,入组患者首先完成常规内镜检查,根据普通白光内镜下病变特点分析病变性质并完成内镜诊断,然后用窄带成像结合放大内镜对病变周围胃小凹及微血管形态进行观察后做出诊断,并根据黏膜像取病理组织检查,将普通白光内镜下诊断及窄带成像放大内镜下诊断分别与病例诊断结果相比较,观察符合率。结果 120例平坦型病变病理证实慢性炎症68例,炎症伴肠上皮化生24例,炎症伴不典型增生18例,早期胃癌10例,普通内镜下诊断总病理符合率为69.2%,窄带成像放大内镜下诊断总病理符合率92.5%,两种情况下总病理符合率差异有统计学意义(P<0.05),尤其在诊断早期胃癌、炎症伴不典型增生、炎症伴肠上皮化生,窄带成像放大内镜明显优于普通白光内镜。结论窄带成像结合放大内镜在胃黏膜平坦型病变的诊断和组织病理学上较普通白光内镜有更好的一致性,且能有效提高胃平坦型早期胃癌及癌前病变的发现率。更多还原

【Abstract】 Objective To research the value of clinic applications of narrow band imaging-magnifying endoscopy(NBI-ME) in the diagnosis of flat gastric lesion.Methods The study was carried out with a group of 120 patients,who were suffering flat gastric lesion.Firstly,general endoscopy examinations were completed.According to the features of lesion under conventional white light endoscopy,diagnosis was finished after analyzing the nature of lesion.Secondly,diagnosis was worked out after observing the morphology of gastric pits and microvascular around the lesions,using narrow band imagingmagnifying endoscopy(NBI-ME).So,on the basis of histopathologic examinations of the mucosal image,the two diagnosis above(the one under conventional white light endoscopy and the other under NBI-ME) were compared separately with the results of case diagnosis,and the rates of consistent were observed.Results Out of all the 120 cases,flat lesion pathology proved that there were 68 cases of chronic inflammation,24 cases of inflammation with intestinal metaplasia,18 cases of inflammation with atypical hyperplasia,10 cases of early gastric carcinoma.The general pathological coincidence rate was 69.2% under common endoscopy,The general pathological coincidence rate was 92.5% under the NBI-ME.The difference of the general pathological coincidence rate under two cases was statistically significant(P<0.05).Especially in the diagnosis of early gastric cancer,inflammation with atypical hyperplasia,inflammation with intestinal metaplasia NBI-ME was better than that of conventional white light endoscopy.Conclusion Narrow band imagingmagnifying endoscopy(NBI-ME) has better consistency than conventional white light endoscopy in the diagnosis of flat gastric lesion and histopathology,and it can effectively improve the discovery rate of early gastric carcinoma and precancerous lesions.更多还原