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自1991年～1996年,我院用奥林巴斯GIF_(K2)型或GIF_(XQ30)型内镜检出贲门癌293例,其中误诊23例,内镜误诊率为7.8%.现将其误诊原因及预防对策报告如下:1 临床资料1.1 一般资料 误诊23例中,男19例,女4例;年龄32岁～74岁,平均52岁.病程半月～26个月,平均6.5个月.临床表现:上腹部胀痛者7例,吞咽不畅者4例,食欲减退、乏力者4例,消瘦、贫血者3例,呕血者3例,黑便者2例.1.2 内镜下表现 病灶部位:黄门小弯5例,贲门小弯偏后壁6例,贲门小弯偏前壁4例,贲门后壁4例,贲门前壁3例,贲门大弯1例.病灶形态:溃疡型8例,隆起肿块样5例,粘膜凹陷4例,粘膜糜烂、粗糙不平4例,粘膜糜烂、渗血2例.病灶大小(直径):小于1.0cm者5例,1.1cm～2.0cm11例,大于2.1cm以上者7例.
From 1991 to 1996, 293 cases of cardiac cancer were detected with Olympus GIF_(K2) or GIF_(XQ30) endoscopes, of which 23 cases were misdiagnosed and the misdiagnosis rate was 7.8%. Misdiagnosis causes and prevention measures are reported as follows: 1 Clinical data 1.1 General information Misdiagnosis 23 cases, 19 males and 4 females; aged 32 years to 74 years, average 52 years old. Duration of half months to 26 months, an average of 6.5 months. Clinical manifestations: 7 cases of abdominal pain, 4 cases of poor swallowing, 4 cases of loss of appetite, fatigue, 3 cases of weight loss, anemia, 3 cases of vomiting, 2 cases of black stool. 1.2 endoscopic lesions Part: 5 cases of small yellow door bend, 6 cases of posterior wall of cardia tendon, 4 cases of cardia tendon anterior wall, 4 cases of cardia posterior wall, 3 cases of fontanel anterior wall, 1 case of cardia major curvature. Lesion morphology: ulcer type In 8 cases, there were 5 cases of swelling masses, 4 cases of mucosal depressions, 4 cases of mucosal erosion, rough and uneventness, 2 cases of mucosal erosion and bleeding, and 5 cases of lesion size (diameter): less than 1.0 cm, 11 cases of 1.1 cm to 2.0 cm, More than 2.1cm in 7 cases.