CAJ | 학술논문

目的探讨CT仿真内镜在低位直肠癌手术治疗策略中的价值.方法收集济宁市第一人民医院胃肠外科2008年8月1日-2011年3月1日收治的低位直肠癌57例患者的病例资料,术前行直肠CT仿真内镜检查,详细记录患者直肠周围组织浸润和淋巴结转移的情况；术后患者常规进行病理检查,比较两者结果的差异.并且比较术前直肠肛诊和直肠CT仿真内镜测量的肿瘤距离肛缘的距离.结果术前直肠CT仿真内镜检查与术后石蜡病理检查对直肠周围淋巴结转移的判断经四格表x2检验,差异无统计学意义(x2=2.5,P＞0.05),其对直肠周围淋巴结转移预测的敏感性达66.7％,特异性93.9％.术前直肠CT仿真内镜预测直肠周围组织浸润和术后病理检查结果经四格表x2检验,差异具有统计学意义(x2 =4.44,P＜0.05),其对直肠癌周围组织浸润判断的敏感性达27.78％,特异性42.86％.直肠肛诊和直肠CT仿真内镜对肿瘤距离肛缘的判断差异无统计学意义(P＞0.05).结论 CT仿真内镜在术前评估低位直肠癌手术治疗策略有较大的意义,应进一步加强研究.
목적 탐토CT방진내경재저위직장암수술치료책략중적개치.방법 수집제저시제일인민의원위장외과2008년8월1일-2011년3월1일수치적저위직장암57례환자적병례자료,술전행직장CT방진내경검사,상세기록환자직장주위조직침윤화림파결전이적정황；술후환자상규진행병리검사,비교량자결과적차이.병차비교술전직장항진화직장CT방진내경측량적종류거리항연적거리.결과 술전직장CT방진내경검사여술후석사병리검사대직장주위림파결전이적판단경사격표x2검험,차이무통계학의의(x2=2.5,P＞0.05),기대직장주위림파결전이예측적민감성체66.7％,특이성93.9％.술전직장CT방진내경예측직장주위조직침윤화술후병리검사결과경사격표x2검험,차이구유통계학의의(x2 =4.44,P＜0.05),기대직장암주위조직침윤판단적민감성체27.78％,특이성42.86％.직장항진화직장CT방진내경대종류거리항연적판단차이무통계학의의(P＞0.05).결론 CT방진내경재술전평고저위직장암수술치료책략유교대적의의,응진일보가강연구.
Objective To explore the value of CT virtual endoscopy in the treatment strategies in low rectal cancer surgery.Methods Fifty- seven cases of rectal cancer in Jining First Hospital were collected,preoperative rectum CT virtual endoscopy,detailed records of patients with rectal invasion and the circumstances surrounding lymph nodes were investigated.Differences were compared in patients after routine pathological examination.And the distance of the tumor from the anal margin was compared with the preoperative rectum on rectal examination and rectal CT virtual endoscopy.Results Preoperative rectum CT virtual endoscopy had no significant difference in evaluation of metastases of the surrounding lymph nodes.Compared with postoperative pathological examination( x2 =2.5,P ＞ 0.05 ),while had significant difference in evaluation in perirectal infiltration( x2 =4.44,P ＜ 0.05 ).Rectal examination and rectum CT virtual endoscopy had no significant difference judgement of the tumor from the anal margin ( P ＞ 0.05 ).Conclusions CT virtual endoscopy has a great significance in the preoperative evaluation of rectal cancer surgical treatment strategies,which should be further studied.