【摘要】 目的:探讨白光内镜、窄带成像技术(NBI)及靛胭酯染色对于鉴别结肠无蒂锯齿状病变(SSL)及增生性息肉(HP)的价值及观察要点。方法:收集深圳市第二人民医院(深圳大学第一附属医院)2015年1月1日至2018年12月31日术后病理明确诊断为结肠SSL及HP的患者,各89例。比较两组患者白光内镜、NBI及靛胭酯染色情况下的表现并进行分析。结果:SSL主要分布于右半结肠,HP主要位于左半结肠,两者的结直肠分布情况比较,差异具有统计学意义(P<0.05);大于0.6 cm的SSL、HP占比与小于0.6 cm的比较,差异无统计学意义(P>0.05);内镜下形态表现为0–Ⅰ型的占比与0–Ⅱa型比较,差异无统计学意义(P>0.05);SSL常见有黏液帽,明显高于HP,差异具有统计学意义(P<0.05);NBI下有91.01 %的SSL隐窝呈黑色扩张,而HP仅有1.12 %,差异具有统计学意义(P<0.05);靛胭酯染色后有95.51 %的SSL为Ⅱ–Open型开口,有3.37 %的HP表现为Ⅱ–Open型开口,差异具有统计学意义(P<0.05)。结论:SSL主要位于右半结肠,往往在白光下表现为表面附着一层黄白色黏液帽,NBI观察隐窝呈扩大黑色开口样,靛胭酯染色后Pit Pattern表现为Ⅱ–Open型,通过以上四点可以有效提高内镜下结肠SSL的诊断率。更多还原

【Abstract】 Objective To investigate the value of white light image,narrow band image and indigo carmine staining image in differentiating SSL and HP of colon.Methods 178 cases with colorectal SSL and HP diagnosed by pathology after operation in our hospital from January 1st 2015 to December 31st 2018 were collected,89 cases each group.Compare the two groups under white light endoscopy image,NBI and indigo carmine staining image.Results SSL was mainly distributed in the right colon,while HP was mainly located in the left colon,the difference was statistically significant (P < 0.05);There was no significant difference in the proportion of SSL and HP greater than 0.6 cm and less than 0.6 cm (P > 0.05);There was no significant difference in the proportion of type 0–Ⅰand type 0–Ⅱa under endoscopy (p > 0.05);The results showed that there was mucus cap in SSL,which was significantly higher than that in HP (P < 0.05);91.01% of SSL had enlarged black opening under NBI,while only 1.12% of HP had enlarged black opening,the difference was statistically significant (P < 0.05);After indigo carmine staining,95.51% of SSL showed Ⅱ–Open Pit Pattern,and 3.37% of HP showed Ⅱ–Open Pit Pattern,the difference was statistically significant (P < 0.05).Conclusion The SSL is mainly located in the right colon,often appearing as a yellow-white mucus cap attached to the surface under white light image.The NBI observes that the crypt is enlarged and black.Pit patterns are II-Open after indigo carmine staining.These appearances can effectively improve the diagnostic rate of colon SSL.更多还原