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目的:探讨胃镜在对于咽喉部恶性疾病诊断的临床应用价值。方法:对2013年11月至2014年9月因声音嘶哑或咽部异物感或吞咽困难为主诉就诊的患者,给予电子喉镜或间接喉镜检查,以在喉镜下发现咽喉部肿物或喉镜下发现黏膜异常增生不能明确判定病灶性质的12例患者为研究对象。继而给予窄带成像(Narrow-band imaging,NBI)及放大胃镜检查,对病灶进行性质及病变范围的判定。病理结果作为金标准,比较喉镜及胃镜两种方式对咽喉恶性病灶的正确诊断率。结果:12例患者中共发现15处病灶,其中炎性反应5处,单纯性鳞状上皮增生3处,鳞状细胞癌6处,神经纤维瘤1处。喉镜对病灶的正确诊断率是40.0%(6/15),NBI放大胃镜对病灶的正确诊断率是93.3%(14/15),两者差异有统计学意义(x~2=9.60,P=0.005)。结论:NBI放大胃镜对咽喉部肿瘤诊断正确率高于普通喉镜,充分证明了胃镜在咽喉部恶性疾病的诊断方面的临床价值。在行胃镜检查时,同时对咽喉部进行仔细观察检查是十分必要的。
Objective: To investigate the clinical value of endoscopy in the diagnosis of malignant throat diseases. METHODS: Patients who were mainly complained of hoarseness or foreign body sensation or difficulty swallowing from November 2013 to September 2014 were given electronic laryngoscopy or indirect laryngoscopy to detect laryngopharyngeal throat mass or The laryngoscope found mucosal dysplasia can not be clearly determine the nature of the lesion in 12 patients for the study. Then give narrow-band imaging (Narrow-band imaging, NBI) and enlarged endoscopy, the nature of the lesion and determine the extent of the lesion. Pathological results as the gold standard, laryngoscope and gastroscopy compare two ways to correct the diagnosis of malignant lesions of the throat. Results: Fifteen lesions were found in 12 patients, including 5 inflammatory reactions, 3 simple squamous cell hyperplasia, 6 squamous cell carcinoma and 1 neurofibroma. The correct diagnosis rate of laryngoscopy was 40.0% (6/15), and the correct diagnosis rate of lesions was 93.3% (14/15%) by NBI magnifying gastroscopy, the difference was statistically significant (x 2 = 9.60, P = 0.005). Conclusion: The diagnostic accuracy of NBI magnifying gastroscopy for throat cancer is higher than that of general laryngoscope, which fully demonstrates the clinical value of endoscopy in the diagnosis of malignant throat diseases. Gastroscopy in the line, while the throat at the same time a careful observation and inspection is very necessary.