Barrett食管治疗后随诊中窄带成像技术的应用分析

Application of Barrett's Esophagus after Treatment Follow-up in Narrowband Imaging Technology

目的：探讨窄带成像技术（NBI）在Barrett食管（BE）随诊中的应用与价值。方法：抽选本院收治的100例BE患者作为观察对象,给予其氩等离子凝固术（APC）与6个月的随访,并在随访中先后给予其内镜与NBI检查,并将结果同病理检查结果进行对比分析。结果：治疗后3个月复诊,45例患者经病理诊断为阳性,而常规内镜检查与NBI检查的敏感性分别为64.44%与88.89%,特异性分别为70.91%与80.0%,比较差异有统计学意义（P〈0.05）;治疗6个月复诊,38例患者经病理检查为阳性,而常规内镜检查与NBI检查敏感性分别为68.42%与92.11%,特异性分别为72.58%与85.48%,比较差异有统计学意义（P〈0.05）。同时,NBI检查病理分型中,Ⅰ级与病理结果比较差异有统计学意义（P〈0.05）,Ⅱ-Ⅲ级与病理活检结果比较差异无统计学意义（P〉0.05）。结论：针对临床BE患者,同常规内镜检查相比,NBI检查确诊率更高。而且在随访中若经NBI诊断为Ⅱ级或Ⅲ级,则表示未愈,需继续接受治疗;若诊断为Ⅰ级,则需结合病理组织检查以明确治疗效果。

Objective：To explore the application and value of narrow band imaging（NBI） in the follow up of Barrett esophagus（BE）.Method：The 100 patients with BE in our hospital were selected as the observation objects,they were given the argon plasma coagulation（APC）,endoscopic and NBI examination at six month follow-up,the results and pathological examination results were compared and analyzed.Result：After treatment for 3 months,45 patients by pathological diagnosis was positive,the sensitivity rate of routine endoscopy and NBI were respectively 64.44% and 88.89%,specificity rate were respectively 70.91% and 80.0%,the differences were statistically significant（P〈0.05）.After treatment for 6 months,38 patients with pathologically positive,the sensitivity rate of routine endoscopy and NBI were respectively 68.42% and 92.11%,specificity rate were respectively 72.58% and 85.48%, the differences were statistically significant（P〈0.05）.At the same time,NBI examination of pathological classification Ⅰ grade compared with pathological results,the difference was statistically significant（P〈0.05）;grade Ⅱ and Ⅲ pathological biopsy results were similar, the difference was no statistically significant（P〉0.05）.Conclusion：For patients with clinical BE,compared with conventional endoscopy,NBI check diagnose rate is high.During follow-up by NBI diagnosis of grade Ⅱ or Ⅲ, healed and need to continue treatment.If diagnosed as grade Ⅰ,combined with pathological examination to confirm the therapeutic effect.