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[目的]探讨窄带成像技术(NBI)在早期大肠癌及癌前病变诊断中的应用价值。[方法]将300例行结肠镜检查的患者随机分为对照组(n=150)和观察组(n=150),分别行普通结肠镜检查和普通结肠镜+NBI检查,对比2组的图像清晰度以及对大肠良恶性肿瘤的诊断准确率。[结果]观察组患者的图像清晰度评分3分及4分者所占比例,均明显高于对照组患者,P<0.05。增生性病变腺管的开口分型以Ⅰ型和Ⅱ型居多,管状腺瘤、管状绒毛腺瘤主要为Ⅲ型,绒毛状腺瘤主要以Ⅳ型,早期癌变的腺管开口以Ⅳ型和Ⅴ型居多,浸润癌主要为Ⅴ型腺管开口。NBI对大肠恶性肿瘤的诊断符合率为93.33%(14/15),对良性肿瘤的诊断符合率为97.73%(43/44),均明显高于常规内镜检查的60.00%(6/10)和77.42%(24/31),P<0.05。[结论]NBI内镜检查能够清晰地显示病变的浅表毛细血管及腺管开口形态,准确预测病变浸润深度,提高早期大肠癌及癌前病变的检出率,指导临床治疗。
[Objective] To explore the value of narrow-band imaging (NBI) in the diagnosis of early colorectal cancer and precancerous lesions. [Methods] Three hundred patients undergoing colonoscopy were randomly divided into control group (n = 150) and observation group (n = 150). Colonoscopy and routine colonoscopy + NBI were performed respectively. Definition and diagnostic accuracy of benign and malignant colorectal tumors. [Results] The patients in the observation group scored 3 points and 4 points respectively, which were significantly higher than those in the control group (P <0.05). Hyperplastic lesions of the open duct type Ⅰ and type Ⅱ majority, tubular adenoma, tubular villous adenoma mainly type Ⅲ, villous adenoma mainly in type Ⅳ, early cancer of the duct opening to type Ⅳ and Ⅴ Most type, invasive carcinoma is mainly Ⅴ type duct openings. The coincidence rate of NBI in the diagnosis of large intestine malignancies was 93.33% (14/15), and the diagnostic accuracy of NBI in benign tumors was 97.73% (43/44), which were significantly higher than 60.00% (6/10) of conventional endoscopy And 77.42% (24/31) respectively, P <0.05. [Conclusion] The endoscopic examination of NBI can clearly show the morphology of superficial capillaries and glands in the lesion, accurately predict the depth of invasion and improve the detection rate of early colorectal cancer and precancerous lesions and guide the clinical treatment.