论文部分内容阅读
早期食管贲门癌仅有粘膜的病理改变,而肌层尚未受到侵犯,故术前定位检查较为困难,往往给外科手术带来麻烦。采用低张气钡双重造影多轴位电视透视,可较为清晰的观察食管贲门粘膜的病理生理改变。在全程拉网的基础上,再分两段拉网,简便易行,定位诊断率可达80%以上。内窥镜检查可靠性较高,但存在有一定误差,检查过程中应对可疑部位做多点刷片活检。术前定位不够明确者,术中应根据术前综合检查结果,做仔细的触摸检查,必要时可做切开涂片活检或术中拉网检查。对术中确实定位困难的患音,术中可根据癌细胞分类选择手术方式。
In the early stage of esophageal and cardiac cancer, only the pathological changes of the mucosa and the muscular layer have not been violated, so the preoperative localization examination is more difficult and often causes trouble for the surgical operation. Using low-contrast double-contrast multi-axial TV perspective, the pathophysiological changes of esophageal and cardiac mucosa can be clearly observed. On the basis of the whole process of pulling the net, it can be divided into two sections to pull the net, which is simple and easy, and the positioning diagnosis rate can reach more than 80%. The reliability of endoscopy is high, but there are certain errors. During the inspection process, multi-point brush biopsy should be performed on suspicious sites. If the preoperative positioning is not well-defined, the surgeon should do a careful touch examination according to the results of the preoperative comprehensive examination, and if necessary, perform an open smear biopsy or an intraoperative pull-net examination. For those patients with difficulty in the surgery, the surgery can be selected according to the classification of the cancer.