CAJ | 학술논문

目的探讨胃癌患者术前钡剂造影检杏对诊断和制订手术方式的临床价值.方法回顾性分析229例胃癌患者的临床资料,将单纯胃镜检查及胃镜联合钡剂造影检查对肿瘤位置和大小的判断结果与手术所见进行比较.结果胃镜对贲门癌、胃体癌和胃窦癌的位置和范围判断的准确率分别为100%和78.4%、94.6%和86.5%以及98.1%和84.6%;胃镜联合钡剂造影检查判断的准确率则分别为100%和84.8%、100%和91.9%以及99.0%和90.4%;胃镜与胃镜联合钡剂造影检查对肿瘤位置和范围判断准确率的差异无统计学意义(P>0.05).胃镜判断贲门癌累及食管长度的准确率为60.6%,胃镜联合钡剂造影检查判断的准确率则为90.9%,两者差异具有统计学意义(P<0.05).胃镜联合钡餐检查较之胃镜能更准确地预测食管受累的贲门癌患者开胸手术的可能性(P<0.05).结论贲门癌患者术前有必要行钡剂造影检查以明确食管下端是否受累及受累长度,对选择手术入路有指导意义,而胃体癌和胃窦癌患者术前在胃镜能明确肿瘤位置和大小的情况下可不必行钡剂造影检查.
목적 탐토위암환자술전패제조영검행대진단화제정수술방식적림상개치.방법 회고성분석229례위암환자적림상자료,장단순위경검사급위경연합패제조영검사대종류위치화대소적판단결과여수술소견진행비교.결과 위경대분문암、위체암화위두암적위치화범위판단적준학솔분별위100%화78.4%、94.6%화86.5%이급98.1%화84.6%;위경연합패제조영검사판단적준학솔칙분별위100%화84.8%、100%화91.9%이급99.0%화90.4%;위경여위경연합패제조영검사대종류위치화범위판단준학솔적차이무통계학의의(P>0.05).위경판단분문암루급식관장도적준학솔위60.6%,위경연합패제조영검사판단적준학솔칙위90.9%,량자차이구유통계학의의(P<0.05).위경연합패찬검사교지위경능경준학지예측식관수루적분문암환자개흉수술적가능성(P<0.05).결론 분문암환자술전유필요행패제조영검사이명학식관하단시부수루급수루장도,대선택수술입로유지도의의,이위체암화위두암환자술전재위경능명학종류위치화대소적정황하가불필행패제조영검사.
Objective To investigate the value of preoperative barium contrast examination for the diagnosis and operative planning in gastric cancer.Methods Clinical data of 229 gastric cancer patients were analyzed retrospectively.Lesions were divided into three parts: the cardiac,the body,and the antrum.The diagnostic accuracy of localization and the extent of tumor between gastroscopy alone and gastroscopy plus barium contrast were compared with the results of surgical findings.Results The diagnostic accuracy of localization and the extent of tumor for gastroscopy in the cardiac,the body and the antrum cancers were 100% and 78.4%,94.6% and 86.5%,98.1% and 84.6%,respectively,while for gastroscopy plus barium contrast were 100% and 84.8%,100% and 91.9%,99.0% and 90.4%,respectively.The diagnostic accuracy of both the localization and the extent of tumor were not significantly different between gastroscopy alone and gastroscopy plus barium contrast(P>0.05).Diagnostic accuracy of the length of esophagus infiltrated by cardiac cancer in gastroscopy was 60.6%,while in gastroscopy plus barium contrast was 90.9%,which was significantly different(P<0.05).Gastroscopy plus barium contrast was more accurate in predicting the possibility of thoracotomy in cardiac cancer infiltrating the lower esophagus.Conclusions It is necessary to perform preoperative barium contrast examination in cardiac cancer patients,so as to identify whether the lower esophagus is infiltrated and to measure the length of lesion,which can provide evidences for making a decision of thoracotomy.For gastric body and antrum cancer,there is no indication for barium contrast examination if gastroscopy findings are satisfied.