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目的通过窄带成像技术(NBI)和染色放大方法对大肠新生性病变进行观察,比较这两种技术对大肠肿瘤及非肿瘤性病变的鉴别诊断精度差异。方法2006年6月至9月间,共302例年龄在20至80岁之间的患者进行了NBI肠镜检查,其中98例入选。内镜插入至回盲部,退镜时分别采用常规模式、NBI模式观察,发现病变后,分别用NBI模式及染色放大方法进行血管分型及腺管开口分型,然后行病理检查进行评价比较。结果在98例患者发现新生性病变147个,其中常规内镜下发现的病变有90．5％(133／147),采用NBI发现病变有98．6％(145／147),差异有统计学意义(P <0．01),漏诊的主要为平坦型病变。NBI观察对肿瘤性或非肿瘤的判断符合率为91．8％,染色内镜为82．3％(P<0．01)。结论NBI技术观察黏膜表面变化,判断肿瘤或非肿瘤病变的符合率比普通内镜和染色内镜高,敏感性强;操作转换简单易行,尤其有利于平坦型病变的发现及诊断。
Objective To observe the neoplasm of colorectal neoplasm by narrowband imaging (NBI) and staining amplification methods, and to compare the accuracy of these two techniques in differential diagnosis of colorectal neoplasms and non-neoplastic lesions. Methods Between June 2006 and September 2006, 302 patients under the age of 20 to 80 years underwent NBI colonoscopy and 98 of them were enrolled. The endoscope was inserted into the ileocecal part. The normal mode and NBI mode were used to observe the lesions respectively. After the lesion was found, the vessels were divided into two groups according to the NBI mode and the method of staining amplification. The pathological examination was performed . Results Of the 98 cases, 147 newborn lesions were found, of which 90.5% (133/147) were found by conventional endoscopy and 98.6% (145/147) by NBI. The difference was statistically significant Significance (P <0.01), the main missed diagnosis of flat lesions. The coincidence rate of NBI observation on tumor or non-tumor was 91.8%, and the staining endoscopy was 82.3% (P <0.01). Conclusion The NBI technique observes the mucosal surface changes and determines the coincidence rate of tumor or non-neoplastic lesions higher than that of ordinary endoscopic and endoscopic methods. The sensitivity of the NBI technique is simple and easy to operate, which is especially helpful for the detection and diagnosis of flat lesions.