无痛胃镜对早期食管癌的诊断价值(1)
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℅(17/107) ，对照组诊断为早期食管癌患者5例，诊断率4.6℅(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
, http://www.100md.com
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.
, http://www.100md.com
Key words：Painless gastroscopy； Early Esophageal Cancer； Diagnosis
食管癌是我國常见恶性肿瘤之一，2011年我国食管癌死亡率为16.3/10万，居各类恶性肿瘤中第4位[1]。目前病因尚未完全明了，可能与饮食刺激，食管的慢性炎症，亚硝胺及其前体，遗传因素及某些病毒感染等有关。食管癌的发病率和死亡率一直居高不下，5年生存率不足10%，而早期诊断与治疗，食管癌术后5年生存率为90﹪以上[2]。由于胃镜检查是浸入性操作，检查能给患者咽喉部、胃肠道产生机械性刺激从而产生恶心、呕吐、疼痛不适等刺激。对食管病变的检查，尤其是食管上段，剧烈的咽喉反应可影响胃镜检查的准确性。我们通过对患者行无痛胃镜检查，并与普通胃镜检查作比较，意在探讨无痛胃镜检查对提高早期食管癌诊断率的影响。
1资料与方法
1.1一般资料 选择2014年2月～2015年10月，随机调查在我院内镜中心行内镜检查的疑是早期食管癌患者214例，其中男128例，女86例，年龄42～81岁，平均年龄66.5岁。临床表现：均有反酸、嗳气、吞咽及胸骨后不适等，所有患者均排除胃镜检查的禁忌症及进展期食管癌。白光胃镜检查肉眼均可观察到食管粘膜充血，粗燥，表浅糜烂及溃疡，轻微隆起及凹陷等可疑病变。将214例患者按随机数字表法分为无痛胃镜组及对照组，每组107例。2组患者的年龄、性别、临床症状，检查医生比较差异无统计学意义，具有可比性。, http://www.100md.com(刘东碧 程红)
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
, http://www.100md.com
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.
, http://www.100md.com
Key words：Painless gastroscopy； Early Esophageal Cancer； Diagnosis
食管癌是我國常见恶性肿瘤之一，2011年我国食管癌死亡率为16.3/10万，居各类恶性肿瘤中第4位[1]。目前病因尚未完全明了，可能与饮食刺激，食管的慢性炎症，亚硝胺及其前体，遗传因素及某些病毒感染等有关。食管癌的发病率和死亡率一直居高不下，5年生存率不足10%，而早期诊断与治疗，食管癌术后5年生存率为90﹪以上[2]。由于胃镜检查是浸入性操作，检查能给患者咽喉部、胃肠道产生机械性刺激从而产生恶心、呕吐、疼痛不适等刺激。对食管病变的检查，尤其是食管上段，剧烈的咽喉反应可影响胃镜检查的准确性。我们通过对患者行无痛胃镜检查，并与普通胃镜检查作比较，意在探讨无痛胃镜检查对提高早期食管癌诊断率的影响。
1资料与方法
1.1一般资料 选择2014年2月～2015年10月，随机调查在我院内镜中心行内镜检查的疑是早期食管癌患者214例，其中男128例，女86例，年龄42～81岁，平均年龄66.5岁。临床表现：均有反酸、嗳气、吞咽及胸骨后不适等，所有患者均排除胃镜检查的禁忌症及进展期食管癌。白光胃镜检查肉眼均可观察到食管粘膜充血，粗燥，表浅糜烂及溃疡，轻微隆起及凹陷等可疑病变。将214例患者按随机数字表法分为无痛胃镜组及对照组，每组107例。2组患者的年龄、性别、临床症状，检查医生比较差异无统计学意义，具有可比性。, http://www.100md.com(刘东碧 程红)
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