目的 :研究接触性内窥镜在喉病变 ,特别是喉癌时做微创的病理学图像检查方法。方法 :在显微支撑喉镜下 ,在 84例喉内病变黏膜处涂 1%的美蓝染色 ,用 6 0×和 15 0×放大倍数的接触式内窥镜 (Karl -Storz 8715AA ,0° ,8715AB ,30° ,直径均为 5 .5mm ,长度 2 3mm)放置于黏膜表面 ,观察其病理变化 ,并与活检结果比较。结果 :接触性内窥镜的电子图像可较清晰的显示表面黏膜不同病变细胞及核的大小、形状、排列、与胞浆的比例、致密度和着色情况 ,有无中空细胞、核角蛋白 ,黏膜下微血管的排列情况。病理改变为 :任克式水肿 (n =8) ,慢性喉炎 (n =15 ) ,喉乳头状瘤 (n =8) ,黏膜白斑 (n =9) ,声带上皮分化不良 (n =18) ,恶性肿瘤 (n =32 ) ,其他 6例。结论 :接触性内窥镜作为一种新的微创的辅助检查方法 ,对喉病变特别是喉癌及早期病变的诊断和动态随访有较大的价值 OBJECTIVE: To study the method of pathological image examination of contact endoscopy in minimally invasive surgery in laryngeal lesions, especially laryngeal cancer. Methods: 84 cases of laryngeal mucosa were smeared with 1% methylene blue under the condition of micro-support laryngoscope. The specimens were examined with contact angle endoscope (Karl-Storz 8715AA, 0 ° , 8715AB, 30 °, diameter of 5.5mm, length of 23mm) placed on the mucosal surface, the pathological changes were observed and compared with the biopsy results. Results: The electronic images of the contact endoscope can clearly show the size, shape, arrangement, cytoplasm proportion, density and coloration of different lesion cells and nuclei on the surface mucosa, whether there are hollow cells, nuclear keratin, Submucosal microvascular arrangement. Pathological changes were Renke’s edema (n = 8), chronic laryngitis (n = 15), laryngeal papilloma (n = 8), leukoplakia (n = 9) , Malignant tumor (n = 32), other 6 cases. Conclusions: As a new and minimally invasive auxiliary examination method, contact endoscopy has great value in the diagnosis and dynamic follow-up of laryngeal diseases, especially laryngeal cancer and early lesions