无痛胃镜对早期食管癌的诊断价值.docVIP

无痛胃镜对早期食管癌的诊断价值 　　摘要：目的 探讨无痛胃镜对提高早期食管癌诊断率的临床应用。方法 将胃镜下怀疑早期食管癌的214例患者按随机数字表法分为2组，每组107例。无痛胃镜组采用专业麻醉师给药，常规口服盐酸达克罗宁胶浆，吸氧、心电监护等，待受检者安静，睫毛及角膜反射消失，开始插镜，检查；对照组除不静脉麻醉外，其余准备同无痛胃镜组进行检查。结果 无痛胃镜组诊断为早期食管癌患者17例，诊断率15.8?G（17/107） ，对照组诊断为早期食管癌患者5例，诊断率4.6?G（5/107）。无痛胃镜组病变检出率高于对照组，差异有统计学意义。结论 无痛胃镜下患者安静，咽、喉反射消失，食管蠕动弱，粘膜易仔细观察，对病变定位及目的性活检有很大帮助，能大大提高活检阳性率，并有利于活检术后局部的观察及止血等。 　　关键词：无痛胃镜检查；早期食管癌；诊断 　　Diagnostic Value of Painless Gastroscopy in Early Esophageal Cancer 　　LIU Dong-bi1，CHENG Hong2 　　（1.Endoscopy Room， Chongqing Three Gorges Central Hospital， Chongqing 404020，China；2.Geriatric Department，Chongqing Three Gorges Central Hospital， Chongqing 404020，China） 　　Abstract：Objective To explore the clinical application of painless gastroscopy in diagnosing early esophageal cancer. Methods 214 cases of suspected early esophageal cancer patients were randomly put into 2 groups， with107 cases in each group. The patients from the painless gastroscopy group were administered anesthetics， routine oxygen inhalation， and ECG monitor. The examinees were inserted with gastroscope and examined after they calmed down and their reflexof eyelash and cornea disappeared. The patients from the contrast group began to receive their examination after routinely taking oral Dyclonine Hydrochloride Mucllage. Results 17 cases in the painless gastroscopy group were diagnosed as early esophageal cancer with the diagnostic rate of 15.8%（17/107） while 5 cases in the contrast group were diagnosed as early esophageal cancer with the diagnostic rate of 4.6%（5/107）. Conclusion With the disappearance of pharyngeal reflexes and the decrease of esophagus movements， the quiet patients receiving painless gastroscopy make it easier for the examiners to carefully observe mucous and locate the disease， which also greatly facilitate objective biopsy， improve the biopsy positive rate， promote post-biopsy observation and hemostasia. 　　Key words：Painless gastroscopy； Early Esophageal Cancer； Diagnosis 　　食管癌是我??常见恶性肿瘤之一，2