小儿纤维胃镜与组织学诊断相关性的探讨

Correlaation between gastroscopic and histologic diagnosis in children

目的探讨小儿纤维胃镜检查诊断上消化道疾病的价值。方法对４２０例患儿胃镜表现与相应的胃、十二指肠粘膜病理改变进行相关分析。结果１．胃镜诊断异常率高于组织学诊断，胃窦部分别为８９．３％（３７５／４２０）、７０．９％（２９８／４２０）、χ２＝１６９．８，Ｐ＜０．００１；球部分别为９４．５％（３９７／４２０）、７１．７％（３０１／４２０），χ２＝１９４．７，Ｐ＜０．００１。（２）胃镜诊断敏感性：胃窦部为８９．９％，球部为９６．７％；与组织学诊断完全符合率：胃窦部为３６．６％（１５４／４２０），球部为３８．３％（１６１／４２０）。结论提示胃镜诊断与组织学改变缺乏相关性，其影响因素较多，胃镜检查结合组织学诊断才能提高其诊断的价值。

Objective The value of gastroscopy in diagnosing upper gastrointestinal disorders in children was to be investigated.Methods An analysis of gastric and duodenal features under gastroscopy and the relative histologic characteristics in 420 cases was performed and their correlation studied.Results More abnormalities were detected under gastroscope than microscope,being 89.3% (375/420) and 70.9%(298/420),χ 2=169.8, P <0.001)respectively at the antrum; 94.5% (397/420) and 71.7%(301/420),χ 2=194.7, P <0.001 at duodenal bulb,the coincidence rate between the two scopic findings remained 36.6%(154/420, at antrum)and 38.3% (161/420,at the bulb). Conclusion As influenced by many factors,there existed poor correlation between gastroscopic and histopathologic findings.Thus what have been found by gastroscope must be identified by microscope to show diagnostic reliability.