内镜窄带成像技术结合放大内镜在鉴别结直肠病变中的作用及其学习曲线
发布时间：2018-07-14 15:07
【摘要】：目的探讨内镜窄带成像技术(NBI)在诊断结直肠病变中的作用。明确NBI在实际操作中的学习曲线,为开展该技术的临床医师提供指导。方法回顾性分析2015年6月-2016年6月该院内镜中心4位医师行NBI结合放大内镜检查并发现结直肠病变的289例患者临床资料,所有病变经活检、内镜下治疗或手术后行病理组织学检查,并与佐野分型对照。根据NBI结合放大内镜分为3组,这3组包括可以通过内镜治疗(目标病变)的病变和不能通过内镜治疗(非目标病变)的病变。每位医师检查的目标或非目标病变均达到15例为1组。通过评估4名医师对每组病变的诊断准确性,绘制NBI结合放大内镜检查技术的相关学习曲线。结果在289例患者的结肠镜检查中共发现372处病变,NBI结合放大内镜使用佐野分型在鉴别肿瘤和非肿瘤性病变的准确率为95.1%、敏感性为98.0%、特异性为92.0%。对于目标及非目标病变的诊断准确率第2组相比第1组均有明显提高[分别为81.7%vs 95.1%(P=0.010)和71.7%vs 93.4%(P=0.000)];第2组与第3组病变之间的诊断准确率的差异无统计学意义(P=0.984及P=0.117)。结论 NBI结合放大内镜是诊断结直肠病变的有效工具。对于无NBI经验的医师在完成较短的训练计划和一定(对目标及非目标病变各15例)的临床实践后基本掌握其诊断方法,并获得有效、稳定的诊断准确率。
[Abstract]:Objective to investigate the role of endoscopic narrowband imaging (NBI) in the diagnosis of colorectal lesions. Define the learning curve of NBI in practice and provide guidance to clinicians who develop this technique. Methods from June 2015 to June 2016, the clinical data of 289 patients with colorectal lesions, who underwent NBI combined with magnification endoscopy, were analyzed retrospectively. All lesions were biopsied. Histopathological examination was performed after endoscopic treatment or surgery, and compared with Sasano classification. According to NBI combined with magnified endoscopy, three groups were divided into three groups, including those which could be treated by endoscopy (target lesions) and those that could not be treated by endoscopy (non-target lesions). There were 15 cases of target or non-target lesions in group 1. The learning curves of NBI combined with magnifying endoscopy were drawn by evaluating the diagnostic accuracy of 4 physicians for each group of lesions. Results in 289 patients with colonoscopy, 372 lesions were detected by NBI combined with magnifying endoscopy. The accuracy of Sawfield classification in differentiating tumor from non-neoplastic lesions was 95.1, sensitivity 98.0 and specificity 92.00.Results in 289 patients, the accuracy of NBI combined with Endoscopic Endoscopic typing was 95.1, the sensitivity was 98.0 and the specificity was 92.0. The diagnostic accuracy of target and non-target lesions in group 2 was significantly higher than that in group 1 [81.7%vs 95.1% (P0. 010) and 71.7%vs 93. 4% (P0. 000)], but there was no significant difference between group 2 and group 3 (P0. 984 and P0. 117). Conclusion NBI combined with magnifying endoscopy is an effective tool for the diagnosis of colorectal lesions. For the doctors without NBI experience, after completing a short training plan and a certain clinical practice (15 cases of target and 15 cases of non-target lesions), the diagnosis method was basically grasped, and the effective and stable diagnostic accuracy was obtained.
【作者单位】： 浙江省丽水市中心医院消化内科;
【分类号】：R574
，
本文编号：2122035
[Abstract]:Objective to investigate the role of endoscopic narrowband imaging (NBI) in the diagnosis of colorectal lesions. Define the learning curve of NBI in practice and provide guidance to clinicians who develop this technique. Methods from June 2015 to June 2016, the clinical data of 289 patients with colorectal lesions, who underwent NBI combined with magnification endoscopy, were analyzed retrospectively. All lesions were biopsied. Histopathological examination was performed after endoscopic treatment or surgery, and compared with Sasano classification. According to NBI combined with magnified endoscopy, three groups were divided into three groups, including those which could be treated by endoscopy (target lesions) and those that could not be treated by endoscopy (non-target lesions). There were 15 cases of target or non-target lesions in group 1. The learning curves of NBI combined with magnifying endoscopy were drawn by evaluating the diagnostic accuracy of 4 physicians for each group of lesions. Results in 289 patients with colonoscopy, 372 lesions were detected by NBI combined with magnifying endoscopy. The accuracy of Sawfield classification in differentiating tumor from non-neoplastic lesions was 95.1, sensitivity 98.0 and specificity 92.00.Results in 289 patients, the accuracy of NBI combined with Endoscopic Endoscopic typing was 95.1, the sensitivity was 98.0 and the specificity was 92.0. The diagnostic accuracy of target and non-target lesions in group 2 was significantly higher than that in group 1 [81.7%vs 95.1% (P0. 010) and 71.7%vs 93. 4% (P0. 000)], but there was no significant difference between group 2 and group 3 (P0. 984 and P0. 117). Conclusion NBI combined with magnifying endoscopy is an effective tool for the diagnosis of colorectal lesions. For the doctors without NBI experience, after completing a short training plan and a certain clinical practice (15 cases of target and 15 cases of non-target lesions), the diagnosis method was basically grasped, and the effective and stable diagnostic accuracy was obtained.
【作者单位】： 浙江省丽水市中心医院消化内科;
【分类号】：R574
，
本文编号：2122035
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