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目的探讨胶囊胃镜对胃黏膜癌前病变早期诊治的临床意义。方法选择2012年9月—2016年1月在襄阳市中心医院诊治的可疑胃黏膜癌前病变患者140例,均进行胶囊胃镜与放大胃镜检查,同时进行病理学检查与对比判断。结果所有患者均完成检查,胶囊内镜的平均检查时间为(478.24±45.22)min,其中通过胃的平均时间为(49.24±22.12)min;放大胃镜的平均检查时间为(75.24±19.21)min。胶囊内镜检查过程中患者未诉任何不适,放大胃镜在检查中出现9例不良反应,发生率为6.4%,所有不良反应经过对症处理后好转。胶囊内镜检出胃黏膜癌前病变108例,检出率为77.1%;而放大胃镜检出111例,检出率为79.3%,对比不同方式下的检出率,差异无统计学意义(P>0.05)。胶囊内镜对于胃黏膜癌前病变诊断的敏感性与特异性为98.2%和100.0%,而放大胃镜诊断的敏感性与特异性为100.0%和96.7%,不同方法的诊断效果对比差异无统计学意义(P>0.05)。结论胶囊胃镜在胃黏膜癌前病变的检查中方便简单,对于机体无明显影响,且检出率较高,定性诊断敏感性与特异性均较好,有很好的临床应用价值。
Objective To investigate the clinical significance of capsule endoscopy in the early diagnosis and treatment of precancerous lesions of gastric mucosa. Methods Seventy-four patients with suspected gastric mucosal precancerous lesions diagnosed and treated in Xiangyang Central Hospital from September 2012 to January 2016 were enrolled in this study. All patients underwent endoscopy and enlarged endoscopy with pathological examination and comparison. Results All the patients completed the examination. The mean time of capsule endoscopy was (478.24 ± 45.22) min, the mean time to pass through the stomach was (49.24 ± 22.12) min and the average time of enucleation of endoscopy was (75.24 ± 19.21) min. Capsule endoscopy during the patient did not complain of any discomfort, enlarged endoscopy in the examination showed 9 cases of adverse reactions, the incidence was 6.4%, all adverse reactions after symptomatic treatment improved. Capsule endoscopy detected gastric mucosal precancerous lesions in 108 cases, the detection rate was 77.1%; 111 cases were magnified gastroscopy detected, the detection rate was 79.3%, compared to different detection methods, the difference was not statistically significant P> 0.05). The sensitivity and specificity of capsule endoscopy for the diagnosis of gastric mucosal precancerous lesions were 98.2% and 100.0%, while the sensitivity and specificity of magnifying endoscopy were 100.0% and 96.7% respectively. There was no significant difference in the diagnostic results between different methods Significance (P> 0.05). Conclusion Capsule gastroscopy in the examination of precancerous lesions of gastric mucosa is simple and convenient, has no obvious effect on the body, and the detection rate is higher, the sensitivity and specificity of qualitative diagnosis are better, and has good clinical value.