电子超声内镜和电子胃镜检查在老年上消化道隆起性病变诊断中的应用价值比较

Comparison of the application value of electronic endoscopic ultrasonography and electronic gastroscopy in the diagnosis of upper gastrointestinal bulge lesions in the elderly

目的 探讨与比较电子超声内镜和电子胃镜检查在老年上消化道隆起性病变诊断中的应用价值。方法 前瞻性选取2018年8月至2022年2月在延安大学附属医院诊治的85例老年上消化道隆起性病变患者,所有患者均给予电子超声内镜和电子胃镜检查。记录患者病变部位性质与分布,记录电子超声内镜及电子胃镜检查时间、不良反应发生情况、影像学特征,判断两者的诊断正确率。结果 在85例老年上消化道隆起性病变患者中,其中间质瘤60例,异位胰腺9例,息肉6例,炎性增生4例,血管性病变4例,囊肿2例。病变部位分布:胃部51例,食管29例,十二指肠5例。良性病变81例,恶性病变4例。电子超声内镜检查时间为(34.19±5.18) min,长于电子胃镜[(30.43±6.06) min],差异有统计学意义(P<0.05)。电子超声内镜检查期间出现的咽喉部不适、恶心、呕吐、腹胀腹痛等不良反应发生率为3.53%,明显低于对照组(16.47%),差异有统计学意义(P<0.05)。间质瘤主要表现为低回声病变,异位胰腺主要表现为低回声病变,息肉表现为黏膜层高回声区,炎性增生表现为各层结构完整,血管性病变表现为黏膜下层无回声结构,囊肿表现为均匀无回声区。电子超声内镜诊断正确率为98.82%,明显高于电子胃镜(87.06%),差异有统计学意义(P<0.05)。结论 相对于电子胃镜,电子超声内镜检查虽然耗时较长,但是可对上消化道隆起性病变进行准确定位,具有很高的诊断正确率,可减少不良反应的发生。

Objective To explore and compare the application values of electronic ultrasound endoscopy and electronic gastroscope in the diagnosis of upper gastrointestinal bulge lesions in the elderly. Methods Prospective analysis of 85 elderly patients with augmentation lesions of the upper gastrointestinal tract seen at the Affiliated Hospital of Yan’an University from August 2018 to February 2022, all patients were given electronic ultrasound endoscopy and electronic gastroscopy. The nature and distribution of lesion sites in patients were recorded, and the time of electronic ultrasound endoscopy and electronic gastroscopy, the occurrence of adverse effects, and imaging characteristics were recorded to determine the correct diagnostic rate of both. Results In the 85 elderly patients with upper gastrointestinal bulge lesions, there were 60 cases of were stromal tumors, 9 cases of were ectopic pancreas, 6 cases of were polyps, 4 cases were inflammatory hyperplasia, 4 cases were vascular lesions, and 2 cases were cysts. The distribution of lesions: 51 cases of stomach, 29 cases of esophagus, and 5 cases of duodenum. There were 81 cases of benign lesions and 4 cases of malignant lesions. The time of electronic endoscopy was(34.19±5.18) min, which was longer than electronic gastroscope [(30.43±6.06) min], the difference was statistically significant(P<0.05). The incidence rates of adverse reactions such as throat discomfort, nausea and vomiting, abdominal distension and abdominal pain during electronic ultrasound endoscopy was 3.53%, which was significantly lower than 16.47% in the control group, the difference was statistically significant(P<0.05). The stromal tumors were mainly hypoechoic lesions, ectopic pancreas was mainly hypoechoic lesions, polyps were mucosal hyperechoic areas, and inflammatory hyperplasia was manifested as layers of structure Intact, vascular lesions appear as anechoic structures in the submucosa, and cysts appear as homogeneous anechoic areas. The correct rate of electronic ultrasound endoscopy was 98.82%, which was significantly higher than that of electronic endoscopy(87.06%), the difference was statistically significant(P<0.05). Conclusion Compared with electronic gastroscopy, although electronic endoscopic ultrasonography is time-consuming, it can accurately locate the elevated lesions of the upper gastrointestinal tract, has a high diagnostic accuracy, can reduce the occurrence of adverse reactions, and shorten the hospitalization time of patients.