消化内镜对慢性萎缩性胃炎的诊断及手术指导价值研究

Study on the Value of Digestive Endoscopy in the Diagnosis and Surgical Guidance of Chronic Atrophic Gastritis

目的:分析消化内镜对慢性萎缩性胃炎(CAG)患者的诊断效能以及对手术方案的指导价值。方法:回顾性分析2021年1月—2022年6月中国人民解放军联勤保障部队第九八八医院焦作院区接受胃镜检查的100例CAG患者将其列为病例组,另将同期接受胃镜检查的32例肺CAG患者列为对照组。根据病理切片诊断结果,计算胃镜对CAG的诊断准确率、敏感度、特异度;统计不同胃肠病变患者的内镜表现,验证胃镜对于CAG等胃肠疾病患者的手术指导价值。结果:以病理切片诊断结果为金标准,胃镜对于CAG的诊断准确率为96.21%、敏感度为97.00%、特异度为93.75%;与病理结果相比,胃镜对CAG的检出率为97.00%、非CAG的检出率为93.75%,其中19例为上皮内瘤变,11例为肠上皮化生;CAG的胃镜表现多以黏膜色泽改变、粗糙不平为主,上皮内瘤变的胃镜表现多以黏膜血管网显露为主,肠上皮化生的胃镜表现多以黏膜色泽改变、粗糙不平为主且伴血管网显露为主。结论:胃镜可实现对CAG的有效诊断,通过观察胃镜下黏膜形态可实现对不同病变类型的有效鉴别,对指导患者手术治疗具有重要意义。

Objective:To analyze the diagnostic efficacy of digestive endoscopy in patients with CAG and its guiding value for surgical planning.Methods:100 patients with CAG who underwent gastroscopy from January 2021 to June 2022 were selected as the study subjects and included in the case group.In addition,32 patients with pulmonary CAG who underwent gastroscopy during the same period were included in the control group for retrospective analysis.The study included two parts:calculation of the diagnostic accuracy,sensitivity,and specificity of gastroscopy for CAG based on the pathological section diagnosis results;statistical analysis of endoscopic findings in patients with different gastrointestinal diseases to verify the value of gastroscopy in surgical guidance for patients with gastrointestinal diseases,such as CAG.Results:Based on the diagnostic results of pathological sections as the gold standard,the diagnostic accuracy of gastroscopy for CAG was 96.21%,the sensitivity was 97.00%,and the specificity was 93.75%.Compared with pathological results,the detection rate of CAG by gastroscopy was 97.00%,and the detection rate of non CAG was 93.75%.Among them,19 cases were intraepithelial neoplasia,and 11 cases were intestinal metaplasia.The gastroscopic manifestations of CAG were mainly mucosal color changes and roughness,while the gastroscopic manifestations of intraepithelial neoplasia were mainly mucosal vascular network exposure.Gastroscopic manifestations of intestinal metaplasia mainly included changes in mucosal color,roughness,and presence of vascular networks.Conclusion:Gastroscope can effectively diagnose CAG,and effectively distinguish different types of lesions by observing the morphology of mucosa under gastroscopy,which is of great significance for guiding surgical treatment of patients.