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Miniature gastrointestinal endoscopy:Now and the future 预览
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作者 John J McGoran Mark E McAlindon +4 位作者 Prasad G Iyer Eric J Seibel Rehan Haidry Laurence B Lovat Sarmed S Sami 《世界胃肠病学杂志:英文版》 SCIE CAS 2019年第30期4051-4060,共10页
Since its original application,gastrointestinal(GI)endoscopy has undergone many innovative transformations aimed at expanding the scope,safety,accuracy,acceptability and cost-effectiveness of this area of clinical pra... Since its original application,gastrointestinal(GI)endoscopy has undergone many innovative transformations aimed at expanding the scope,safety,accuracy,acceptability and cost-effectiveness of this area of clinical practice.One method of achieving this has been to reduce the caliber of endoscopic devices.We propose the collective term“Miniature GI Endoscopy”.In this Opinion Review,the innovations in this field are explored and discussed.The progress and clinical use of the three main areas of miniature GI endoscopy(ultrathin endoscopy,wireless endoscopy and scanning fiber endoscopy)are described.The opportunities presented by these technologies are set out in a clinical context,as are their current limitations.Many of the positive aspects of miniature endoscopy are clear,in that smaller devices provide access to potentially all of the alimentary canal,while conferring high patient acceptability.This must be balanced with the costs of new technologies and recognition of device specific challenges.Perspectives on future application are also considered and the efforts being made to bring new innovations to a clinical platform are outlined.Current devices demonstrate that miniature GI endoscopy has a valuable place in investigation of symptoms,therapeutic intervention and screening.Newer technologies give promise that the potential for enhancing the investigation and management of GI complaints is significant. 展开更多
关键词 ULTRATHIN ENDOSCOPY CAPSULE ENDOSCOPY SINGLE FIBER ENDOSCOPY
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Role of endoscopy in acute gastrointestinal bleeding in real clinical practice:An evidence-based review 预览
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作者 Kyoungwon Jung Won Moon 《世界胃肠内镜杂志:英文版(电子版)》 2019年第2期68-83,共16页
Although upper gastrointestinal bleeding is usually segregated from lower gastrointestinal bleeding,and guidelines for gastrointestinal bleeding are divided into two separate sections,they may not be distinguished fro... Although upper gastrointestinal bleeding is usually segregated from lower gastrointestinal bleeding,and guidelines for gastrointestinal bleeding are divided into two separate sections,they may not be distinguished from each other in clinical practice.Most patients are first observed with signs of bleeding such as hematemesis,melena,and hematochezia.When a patient with these symptoms presents to the emergency room,endoscopic diagnosis and treatment are considered together with appropriate initial resuscitation.Especially,in cases of variceal bleeding,it is important for the prognosis that the endoscopy is performed immediately after the patient stabilizes.In cases of suspected lower gastrointestinal bleeding,full colonoscopy after bowel preparation is effective in distinguishing the cause of the bleeding and treating with hemostasis.The therapeutic aspect of endoscopy,using the mechanical method alone or injection with a certain modality rather than injection alone,can increase the success rate of bleeding control.Therefore,it is important to consider the origin of bleeding and how to approach it.In this article,we aim to review the role of endoscopy in diagnosis,treatment,and prognosis in patients with acute gastrointestinal bleeding in a real clinical setting. 展开更多
关键词 ENDOSCOPY GASTROINTESTINAL BLEEDING ENDOSCOPIC BLEEDING control Emergency BOWEL preparation BEDSIDE ENDOSCOPY Second-look ENDOSCOPY
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Training in video capsule endoscopy: Current status and unmet needs 预览
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作者 Apostolos Koffas Faidon-Marios Laskaratos Owen Epstein 《世界胃肠内镜杂志:英文版(电子版)》 2019年第6期395-402,共8页
Since its introduction to clinical practice nearly 20 years ago, wireless capsule endoscopy has revolutionized the landscape in the diagnosis and management of small bowel diseases. Over the past 10 years, capsule end... Since its introduction to clinical practice nearly 20 years ago, wireless capsule endoscopy has revolutionized the landscape in the diagnosis and management of small bowel diseases. Over the past 10 years, capsule endoscopy has evolved beyond the small intestine and a range of capsules are now available to examine the esophagus, stomach and colon. Because of its ease of use, tolerability, paucity of complications and ability to visualize the entire gastrointestinal tract, capsule endoscopy has entered the mainstream of clinical practice. This review of the literature summarizes the current state of capsule training and highlights the limited data available to assess reader competence and standards expected of an independent practitioner. There are neither standardized teaching strategies nor national or international metrics for accreditation of physicians and nonphysicians interested in mastering this examination. Summating the few publications, there appears to be consensus that diagnostic expertise improves with experience, and that trainees should be fully supervised for at least 20 full case studies. Formative and summative assessment is advisable and the number of taught cases should not be the sole determinant of competence. The review also highlights differences in recommendations from major national gastroenterology societies. Finally, the authors discuss areas of unmet needs in teaching and learning for capsule endoscopy. 展开更多
关键词 SMALL BOWEL CAPSULE ENDOSCOPY COLON CAPSULE ENDOSCOPY TRAINING
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Device-assisted enteroscopy: A review of available techniques and upcoming new technologies 预览
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作者 Markus Schneider Jorg Hollerich Torsten Beyna 《世界胃肠病学杂志:英文版》 SCIE CAS 2019年第27期3538-3545,共8页
The advent of video capsule endoscopy into clinical routine more than 15 years ago led to a substantial change in the diagnostic approach to patients with suspected small bowel diseases, often indicating a deep entero... The advent of video capsule endoscopy into clinical routine more than 15 years ago led to a substantial change in the diagnostic approach to patients with suspected small bowel diseases, often indicating a deep enteroscopy procedure for diagnostical confirmation or endoscopic treatment. Device assisted enteroscopy was developed in 2001 and for the first time established a practicable, safe and effective method for evaluation of the small bowel.Currently with double-balloon enteroscopy, single-balloon enteroscopy and spiral enteroscopy three different platforms are available in clinical routine.Summarizing, double-balloon enteroscopy seems to offer the deepest insertion depth to the small bowel going hand in hand with the disadvantage of a longer procedural duration. Manual spiral enteroscopy seems to be a faster procedure but without reaching the depth of the DBE in currently available data. Finally,single-balloon enteroscopy seems to be the least complicated procedure to perform. Despite substantial improvements in the field of direct enteroscopy,even nowadays deep endoscopic access to the small bowel with all available methods is still a complex procedure, cumbersome and time-consuming and requires high endoscopic skills. This review will give an overview of the currently available techniques and will further discuss the role of the upcoming new technology of the motorized spiral enteroscopy(PowerSpiral). 展开更多
关键词 Small BOWEL disease CAPSULE ENDOSCOPY ENTEROSCOPY PowerSpiral ENTEROSCOPY ENDOSCOPY
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肠气囊肿症的临床及内镜下特点分析 预览
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作者 黎俊 杨柳 董丽凤 《中国内镜杂志》 2019年第9期53-58,共6页
目的探讨肠气囊肿症(PCI)的临床、内镜下特点及诊治方法,以提高认识。方法回顾性分析北京市垂杨柳医院诊断的10例PCI患者的临床、内镜特点和治疗效果,分析误诊原因。结果10例PCI患者均经肠镜明确诊断,病变主要位于右半结肠,立位腹平片... 目的探讨肠气囊肿症(PCI)的临床、内镜下特点及诊治方法,以提高认识。方法回顾性分析北京市垂杨柳医院诊断的10例PCI患者的临床、内镜特点和治疗效果,分析误诊原因。结果10例PCI患者均经肠镜明确诊断,病变主要位于右半结肠,立位腹平片和腹部CT可见沿肠管分布的大小不等的葡萄样囊腔。经吸氧、肠道益生菌及内镜治疗后,所有患者症状明显缓解。结论PCI是一种罕见疾病,临床症状缺乏特征性,以腹痛、腹泻和腹胀等消化道症状多见,容易误诊。内镜下使用注射针穿刺抽吸囊泡内气体,是一种有效的治疗方法。 展开更多
关键词 肠气囊肿症 结肠 囊肿 内镜检查 诊断 内镜治疗 体层摄影术
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Endoscopic characteristics of small intestinal malignant tumors observed by balloon-assisted enteroscopy 预览
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作者 Tomofumi Horie Naoki Hosoe +10 位作者 Kaoru Takabayashi Yukie Hayashi Kenji JL Limpias Kamiya Ryoichi Miyanaga Shinta Mizuno Kayoko Fukuhara Seiichiro Fukuhara Makoto Naganuma Masayuki Shimoda Haruhiko Ogata Takanori Kanai 《世界胃肠内镜杂志:英文版(电子版)》 2019年第5期373-382,共10页
BACKGROUND Capsule endoscopy and balloon-assisted enteroscopy (BAE) enable visualization of rare small bowel conditions such as small intestinal malignant tumors. However, details of the endoscopic characteristics of ... BACKGROUND Capsule endoscopy and balloon-assisted enteroscopy (BAE) enable visualization of rare small bowel conditions such as small intestinal malignant tumors. However, details of the endoscopic characteristics of small intestinal malignant tumors are still unknown. AIM To elucidate the endoscopic characteristics of small intestinal malignant tumors. METHODS From March 2005 to February 2017, 1329 BAE procedures were performed at Keio University Hospital. Of these procedures, malignant tumors were classified into three groups, Group 1: epithelial tumors including primary small intestinal cancer, metastatic small intestinal cancer, and direct small intestinal invasion by an adjacent organ cancer;Group 2: small intestinal malignant lymphoma;and Group 3, small intestinal gastrointestinal stromal tumors. We systematically collected clinical and endoscopic data from patients’ medical records to determine the endoscopic characteristics for each group.RESULTS The number of patients in each group was 16 (Group 1), 23 (Group 2), and 6 (Group 3), and the percentage of solitary tumors was 100%, 43.5%, and 100%, respectively (P < 0.001). Patients’ clinical background parameters including age, symptoms, and laboratory data were not significantly different between the groups. Seventy-five percent of epithelial tumors (Group 1) were located in the upper small intestine (duodenum and ileum), and approximately 70% of gastrointestinal stromal tumors (Group 3) were located in the jejunum. Solitary protruding or mass-type tumors were not seen in malignant lymphoma (Group 2)(P < 0.001). Stenosis was seen more often in Group 1,(68.8%, 27.3%, and 0%;Group 1, 2, and 3, respectively;P = 0.004). Enlarged white villi inside and/or surrounding the tumor were seen in 12.5%, 54.5%, and 0% in Group 1, 2, and 3, respectively (P = 0.001). CONCLUSION The differential diagnosis of small intestinal malignant tumors could be tentatively made based on BAE findings. 展开更多
关键词 Small INTESTINE MALIGNANT Tumor Double BALLOON ENTEROSCOPY BALLOON ENTEROSCOPY Video CAPSULE ENDOSCOPY ENDOSCOPY
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Endoscopic response to tumor necrosis factor inhibitors predicts long term benefits in Crohn’s disease 预览
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作者 Ignacio Alfaro Maria Carme Masamunt +10 位作者 Nuria Planell Alicia López-García Jesús Castro Marta Gallego Rebeca Barastegui Angel Giner Alejandro Vara Azucena Salas Elena Ricart Julián Panés Ingrid Ordás 《世界胃肠病学杂志:英文版》 SCIE CAS 2019年第14期1764-1774,共11页
BACKGROUND Identifying predictors of therapeutic response is the cornerstone of personalized medicine. AIM To identify predictors of long-term mucosal healing (MH) in patients with Crohn's disease (CD) treated wit... BACKGROUND Identifying predictors of therapeutic response is the cornerstone of personalized medicine. AIM To identify predictors of long-term mucosal healing (MH) in patients with Crohn's disease (CD) treated with tumor necrosis factor α(TNF-α) inhibitors. METHODS Prospective single center study. Consecutive patients with clinically active CD requiring treatment with a TNF-α inhibitor were included. A baseline segmental CD Endoscopic Index of Severity (CDEIS)≥ 10 in at least one segment or the presence of ulcerations were required for inclusion. Clinical, biological and endoscopic data were obtained at baseline, weeks 14 and 46. Endoscopic response (ER) was defined as a decrease ≥ 50% from baseline CDEIS and MH as partial CDEIS ≤ 5 in all segments. RESULTS Of 62 patients were included. At baseline, median CD Activity Index and CDEIS were 201 and 6.7, respectively with a significant reduction after one year of treatment (53 and 3.0 respectively, P < 0.001). At week 14, 56% of patients achieved ER and 34% MH. At week 46, the corresponding percentages were 52% and 44%. Baseline disease characteristics or biomarkers did not predict MH. A decrease from baseline CDEIS at week 14 of at least 80% was the best predictor of MH at week 46 (59% sensitivity and 91% specificity;area under the curve = 0.778).CONCLUSION Clinical and biomarker data are not useful predictors of response to TNF-α inhibitors in CD, whereas ER to induction therapy, defined as 80% reduction in global CDEIS, is a robust predictor of long-term MH. Achievement of this endoscopic endpoint may be considered as a therapeutic target for anti-TNF-α therapy. 展开更多
关键词 Crohn’s DISEASE Endoscopy MUCOSAL HEALING Crohn’s DISEASE ENDOSCOPIC Index of SEVERITY Tumor NECROSIS factor
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Stricter national standards are required for credentialing of endoscopic-retrograde-cholangiopan-creatography in the United States 预览
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作者 Mitchell S Cappell David M Friedel 《世界胃肠病学杂志:英文版》 SCIE CAS 2019年第27期3468-3483,共16页
Endoscopic-retrograde-cholangiopancreatography(ERCP) is now a vital modality with primarily therapeutic and occasionally solely diagnostic utility for numerous biliary/pancreatic disorders. It has a significantly stee... Endoscopic-retrograde-cholangiopancreatography(ERCP) is now a vital modality with primarily therapeutic and occasionally solely diagnostic utility for numerous biliary/pancreatic disorders. It has a significantly steeper learning curve than that for other standard gastrointestinal(GI) endoscopies, such as esophagogastroduodenoscopy or colonoscopy, due to greater technical difficulty and higher risk of complications. Yet, GI fellows have limited exposure to ERCP during standard-three-year-GI-fellowships because ERCP is much less frequently performed than esophagogastroduodenoscopy/colonoscopy. This led to adding an optional year of training in therapeutic endoscopy. Yet many graduates from standard three-year-fellowships without advanced training intensely pursue independent/unsupervised ERCP privileges despite inadequate numbers of performed ERCPs and unacceptably low rates of successful selective cannulation of desired(biliary or pancreatic) duct. Hospital credentialing committees have traditionally performed ERCP credentialing, but this practice has led to widespread flouting of recommended guidelines(e.g., planned privileging of applicant with 20% successful cannulation rate, or after performing only 7 ERCPs);and intense politicking of committee members by applicants, their practice groups, and potential competitors. Consequently, some gastroenterologists upon completing standard fellowships train and learn ERCP 'on the job' during independent/unsupervised practice, which can result in bad outcomes: high rates of failed bile duct cannulation. This severe clinical problem is indicated by publication of ≥ 12 ERCP competency studies/guidelines during last 5 years. However, lack of mandatory, quantitative, ERCP credentialing criteria has permitted neglect of recommended guidelines. This work comprehensively reviews literature on ERCP credentialing;reviews rationales for proposed guidelines;reports problems with current system;and proposes novel criteria for competency. This work advocates for mandatory, national 展开更多
关键词 Endoscopic retrograde CHOLANGIOPANCREATOGRAPHY Privileges CREDENTIALING Gastroenterology FELLOWSHIP TRAINING Advanced gastrointestinal endoscopy TRAINING Certification Standards
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关节镜下跟骨骨刺切除联合足底跖筋膜松解术治疗足跟痛的临床疗效 预览
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作者 吴晗 吕浩 +1 位作者 程文丹 荆珏华 《局解手术学杂志》 2019年第6期442-445,共4页
目的探讨关节镜下跟骨骨刺切除联合足底跖筋膜松解术治疗足跟痛的可行性及疗效。方法回顾性分析2015年1月至2017年12月43例跟骨刺疼痛患者的临床资料,所有患者均行关节镜下疼痛跟骨刺切除联合足底筋膜松解术,术后随访6~12个月。除常规... 目的探讨关节镜下跟骨骨刺切除联合足底跖筋膜松解术治疗足跟痛的可行性及疗效。方法回顾性分析2015年1月至2017年12月43例跟骨刺疼痛患者的临床资料,所有患者均行关节镜下疼痛跟骨刺切除联合足底筋膜松解术,术后随访6~12个月。除常规足部检查外,采用VAS评分系统评估足部的疼痛程度。采用AOFAS-AH评分系统对足痛、自主活动、步态和稳定性进行综合评价。结果VAS评分由术前的(8.71±1.64)分降为术后6个月的(6.28±2.44)分,差异具有统计学意义(P<0.05)。AOFAS-AH评分从术前的(56.43±3.72)分增加至术后6个月的(94.51±2.93)分,差异具有统计学意义(P<0.05)。结论关节镜下跟骨骨刺切除联合足底跖筋膜松解术治疗足跟痛术后疼痛缓解快、足部功能恢复快,微创手术效果满意,具有较大的临床可行性和优越性。 展开更多
关键词 关节镜 跟骨骨刺 跖筋膜 治疗 跟痛症
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经皮肾镜取石术患者围手术期应用加速康复外科理念的探讨 预览
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作者 张华 毛厚平 +3 位作者 江涛 陈沁 何彦丰 陈文炜 《福建医科大学学报》 2019年第3期187-190,共4页
目的 探讨经皮肾镜取石术(PCNL)患者围手术期应用加速康复外科(ERAS)理念的临床价值。 方法 收集135例PCNL患者的临床资料,根据是否应用ERAS分为ERAS组和传统组。ERAS组62例患者围术期采用ERAS处理模式,传统组73例患者围术期采用传统处... 目的 探讨经皮肾镜取石术(PCNL)患者围手术期应用加速康复外科(ERAS)理念的临床价值。 方法 收集135例PCNL患者的临床资料,根据是否应用ERAS分为ERAS组和传统组。ERAS组62例患者围术期采用ERAS处理模式,传统组73例患者围术期采用传统处理模式;比较两组患者术后首次饮水时间、首次肛门排气时间、视觉模拟评分法(VAS)疼痛评分、下床活动和导尿管留置时间、手术并发症发生率、住院天数等的差异。 结果 ERAS组患者术后首次饮水和肛门排气时间、首次下床活动和导尿管留置时间、住院天数均短于传统组(P<0.05),术后24、48hVAS评分也低于传统组(P<0.05)。 结论 在PCNL围手术期应用ERAS指导,可明显加速术后康复,改善患者预后。 展开更多
关键词 加速康复外科 围手术期护理 结石 内窥镜检查 肾造口术 经皮
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内镜粘膜活检组织的病理诊断思路及陷阱 预览
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作者 唐治蓉 龙琼先 +1 位作者 刘欣雅 廖文华 《中国实验诊断学》 2019年第1期6-9,共4页
目的探讨消化内镜粘膜活检组织的病理诊断思路及其陷阱,提高消化内镜粘膜活检组织的病理诊断准确率。方法回顾性分析17737例消化内镜粘膜活检组织的常规HE染色及部分病例的免疫组化染色结果,分析其病理诊断中的陷进及注意事项。结果 17... 目的探讨消化内镜粘膜活检组织的病理诊断思路及其陷阱,提高消化内镜粘膜活检组织的病理诊断准确率。方法回顾性分析17737例消化内镜粘膜活检组织的常规HE染色及部分病例的免疫组化染色结果,分析其病理诊断中的陷进及注意事项。结果 17737例消化内镜粘膜组织中,经常规HE染色而明确诊断的病例有16786例,另有951例经常规HE染色观察下无法确诊的病例,其镜下形态多为无法判断组织来源的异型细胞团、肿瘤组织过少、组织挤压严重、坏死背景严重或HE切片染色质量欠佳。经过再次切片、染色明确诊断652例,其中恶性肿瘤214例;经过免疫组织化学或组织化学染色后明确诊断299例,其中恶性肿瘤159例。结论在诊断消化内镜粘膜活检组织的过程中,病理医师必须认识到存在的诊断陷阱,一定要结合内镜下检查,特殊情况下,需要再次切片、染色或进行免疫组化染色辅助诊断,以避免漏诊、误诊。 展开更多
关键词 肿瘤 病理诊断 内镜检查 活检组织
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Quest for the best endoscopic imaging modality for computer-assisted colonic polyp staging 预览
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作者 Georg Wimmer Michael Gadermayr +8 位作者 Gernot Wolkersd?rfer Roland Kwitt Toru Tamaki Jens Tischendorf Michael H?fner Shigeto Yoshida Shinji Tanaka Dorit Merhof Andreas Uh 《世界胃肠病学杂志:英文版》 SCIE CAS 2019年第10期1197-1209,共13页
BACKGROUND It was shown in previous studies that high definition endoscopy, high magnification endoscopy and image enhancement technologies, such as chromoendoscopy and digital chromoendoscopy [narrow-band imaging(NBI... BACKGROUND It was shown in previous studies that high definition endoscopy, high magnification endoscopy and image enhancement technologies, such as chromoendoscopy and digital chromoendoscopy [narrow-band imaging(NBI), iScan] facilitate the detection and classification of colonic polyps during endoscopic sessions. However, there are no comprehensive studies so far that analyze which endoscopic imaging modalities facilitate the automated classification of colonic polyps. In this work, we investigate the impact of endoscopic imaging modalities on the results of computer-assisted diagnosis systems for colonic polyp staging.AIM To assess which endoscopic imaging modalities are best suited for the computerassisted staging of colonic polyps.METHODS In our experiments, we apply twelve state-of-the-art feature extraction methods for the classification of colonic polyps to five endoscopic image databases of colonic lesions. For this purpose, we employ a specifically designed experimental setup to avoid biases in the outcomes caused by differing numbers of images per image database. The image databases were obtained using different imaging modalities. Two databases were obtained by high-definition endoscopy in combination with i-Scan technology(one with chromoendoscopy and one without chromoendoscopy). Three databases were obtained by highmagnification endoscopy(two databases using narrow band imaging and one using chromoendoscopy). The lesions are categorized into non-neoplastic and neoplastic according to the histological diagnosis.RESULTS Generally, it is feature-dependent which imaging modalities achieve high results and which do not. For the high-definition image databases, we achieved overall classification rates of up to 79.2% with chromoendoscopy and 88.9% without chromoendoscopy. In the case of the database obtained by high-magnification chromoendoscopy, the classification rates were up to 81.4%. For the combination of high-magnification endoscopy with NBI, results of up to 97.4% for one database and up to 84% fo 展开更多
关键词 Endoscopy Colonic POLYPS Automated diagnosis system NARROW-BAND IMAGING CHROMOENDOSCOPY IMAGING MODALITIES Image enhancement technologies
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内镜下RFA结合基础疗法对慢性隆起糜烂型胃炎患者的效果及胃肠激素水平的影响 预览
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作者 徐凡莉 熊倩 徐志军 《现代消化及介入诊疗》 2019年第9期957-960,共4页
目的探讨内镜下射频消融术(RFA)辅助基础疗法治疗慢性隆起糜烂型胃炎患者的效果及对胃肠道激素的影响。方法选取武汉科技大学附属孝感医院经胃镜检查确诊的93例慢性隆起糜烂性胃炎患者,采用随机区组设计分为观察组(47例)和对照组(46例)... 目的探讨内镜下射频消融术(RFA)辅助基础疗法治疗慢性隆起糜烂型胃炎患者的效果及对胃肠道激素的影响。方法选取武汉科技大学附属孝感医院经胃镜检查确诊的93例慢性隆起糜烂性胃炎患者,采用随机区组设计分为观察组(47例)和对照组(46例)。观察组患者采用内镜下RFA治疗+基础三联疗法(奥美拉唑+阿莫西林+克拉霉素)治疗,对照组患者仅给予基础三联疗法治疗;对比两组的临床疗效、幽门螺杆菌(H.pylori)根除率、血清胃动素、瘦素、胃泌素、血管活性肠肽(VIP)的变化。结果治疗后,观察组的临床疗效显著的优于对照组(P<0.05);观察组的H.pylori根除率为90.48%、对照组为83.72%,两组比较差异无统计学意义(P>0.05)。治疗前,两组的血清胃动素、瘦素、胃泌素、VIP水平比较,差异均无统计学意义(P>0.05);治疗后,观察组的的血清胃泌素、VIP水平显著低于对照组(P均<0.05),观察组的血清胃动素、瘦素水平显著的高于对照组(P均<0.05)。结论内镜下RFA辅助基础疗法治疗慢性隆起糜烂型胃炎患者对于促进糜烂面的愈合具有一定的作用,糜烂面愈合后对于患者胃肠道激素水平的改善也具有一定的作用。 展开更多
关键词 内镜 射频消融术 隆起糜烂型 胃炎 胃肠道激素
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白光内镜与放大内镜联合窄带光成像技术对良性病变中肠型胃腺瘤的诊断作用比较
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作者 滕腊梅 章庆伟 +3 位作者 张昕恬 陈锦南 周菁 李晓波 《中华消化内镜杂志》 CSCD 北大核心 2019年第8期558-562,共5页
目的比较常规白光内镜与放大内镜联合窄带光成像技术在良性病变中诊断肠型胃腺瘤的准确性。方法收集2016年1月至2017年12月在上海仁济医院消化内镜中心经白光内镜检查怀疑胃早期肿瘤性病变的连续患者,择期再次行白光内镜及放大内镜联合... 目的比较常规白光内镜与放大内镜联合窄带光成像技术在良性病变中诊断肠型胃腺瘤的准确性。方法收集2016年1月至2017年12月在上海仁济医院消化内镜中心经白光内镜检查怀疑胃早期肿瘤性病变的连续患者,择期再次行白光内镜及放大内镜联合窄带光成像检查,分别记录其内镜诊断结果,并以活检或术后病理诊断为评判标准,除外癌变病灶,比较白光内镜和放大内镜联合窄带光成像内镜在良性病灶中区分肠型胃腺瘤和其他非腺瘤病变的诊断准确性。结果共纳入232例患者(232个病灶),其中肠型胃腺瘤124例,其他非腺瘤性良性病灶(萎缩、溃疡、增生、非肠型胃腺瘤相关低级别上皮内瘤变等)108例,放大内镜联合窄带光成像区分肠型胃腺瘤与非腺瘤性良性病变的灵敏度、阴性预测值、准确率均显著高于白光内镜(分别为92.7%比71.8%,91.6%比73.7%,91.8%比80.6%,P均<0.01),特异度一致(均为90.7%),阳性预测值和白光内镜相比(92.0%比89.9%),差异无统计学意义(P>0.05)。结论放大内镜联合窄带光成像鉴别肠型胃腺瘤与非腺瘤性良性病变的诊断效能显著高于白光内镜。 展开更多
关键词 腺瘤 胃肿瘤 内窥镜检查 胃肠道 窄带光成像
标准化护理干预在胃溃疡合并糖尿病患者内镜检查中的护理效果 预览
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作者 段会苓 邹正云 刘玉芝 《糖尿病新世界》 2019年第2期22-24,共3页
目的探讨标准化护理干预在胃溃疡合并糖尿病患者内镜检查中的护理效果。方法选取112例于2017年4月—2018年4月在该院进行内镜检查的胃溃疡合并糖尿病患者为研究对象,依护理方法不同将其分为对照组和研究组,分别给予常规护理与标准化护... 目的探讨标准化护理干预在胃溃疡合并糖尿病患者内镜检查中的护理效果。方法选取112例于2017年4月—2018年4月在该院进行内镜检查的胃溃疡合并糖尿病患者为研究对象,依护理方法不同将其分为对照组和研究组,分别给予常规护理与标准化护理干预,比较两组患者护理前后的血糖水平变化情况及不良反应的发生情况。结果两组患者护理前的FPG与2hPG水平比较差异无统计学意义(P>0.05),护理后均有所下降,且研究组患者护理后的FPG与2hPG水平明显优于对照组,组间比较差异有统计学意义(P<0.05)。结论针对胃溃疡合并糖尿病患者,在行内镜检查的过程当中给予其标准化护理干预有利患者血糖水平的稳定,减少不良反应的发生,促进检查的顺利完成,值得在临床沼上推广应用。 展开更多
关键词 胃溃疡 糖尿病 内镜检查
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不同剂量奥美拉唑联合内镜下止血治疗PU合并UGB效果比较 预览
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作者 李君 牟一 王俊益 《西南国防医药》 CAS 2019年第3期323-326,共4页
目的观察不同剂量奥美拉唑联合内镜下止血治疗消化性溃疡(PU)合并上消化道出血(UGB)疗效。方法随机将120例PU合并UGB患者分为内镜下止血术联合高剂量(首剂量80mg,再予以8mg/h,维持3d;之后改静脉注射40mg/次,1次/12h,共治疗5d)奥美拉唑组... 目的观察不同剂量奥美拉唑联合内镜下止血治疗消化性溃疡(PU)合并上消化道出血(UGB)疗效。方法随机将120例PU合并UGB患者分为内镜下止血术联合高剂量(首剂量80mg,再予以8mg/h,维持3d;之后改静脉注射40mg/次,1次/12h,共治疗5d)奥美拉唑组(研究组,n=60)和内镜下止血术联合常规剂量(40mg/次,1次/12h,共治疗5d)奥美拉唑组(对照组,n=60)。比较两组治疗12、24、48h时的止血效果和空腹胃液pH值差异;比较两组住院时间、大便隐血转阴时间和治疗5d内不良反应情况。结果在12、24、48h时,研究组止血率和空腹胃液pH值均大于对照组,再出血率、大便隐血转阴时间则小于对照组(P<0.05)。两组住院时间、不良反应发生率无统计学差异(P>0.05)。结论高剂量奥美拉唑联合内镜下止血术治疗PU合并UGB可显著增强止血效果,降低再出血率,且安全性良好。 展开更多
关键词 内镜 止血术 奥美拉唑 消化性溃疡 上消化道出血 效果
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耳内镜外科在基层医院大有可为
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作者 郑亿庆 张雪媛 杨海弟 《中国耳鼻咽喉头颈外科》 CSCD 2019年第7期343-345,共3页
耳外科的进展始于手术显微镜的使用。1952年Wullstein首次将显微镜用于耳科手术,奠定了耳显微外科的基础。随后,耳显微外科技术不断提高,手术范围逐渐扩大,由中耳进展到内耳和侧颅底区。沿用至今,手术显微镜一直是耳外科最常用的技术手... 耳外科的进展始于手术显微镜的使用。1952年Wullstein首次将显微镜用于耳科手术,奠定了耳显微外科的基础。随后,耳显微外科技术不断提高,手术范围逐渐扩大,由中耳进展到内耳和侧颅底区。沿用至今,手术显微镜一直是耳外科最常用的技术手段。但耳显微外科手术难度高,能够熟练使用手术显微镜的耳外科医师的成才时间相对较长,在基层医院难以培养,同时,手术显微镜昂贵的价格也让很多基层医院望而却步,这些都限制了耳科手术在省级以下医院的开展. 展开更多
关键词 耳外科手术 内窥镜检查 基层医院
耳内镜下经耳道入路中耳胆脂瘤手术疗效分析
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作者 杨海弟 高敏倩 +1 位作者 郑亿庆 张志钢 《中国耳鼻咽喉头颈外科》 CSCD 2019年第7期346-349,共4页
目的探讨耳内镜下经耳道入路中耳胆脂瘤手术的可行性及疗效。方法回顾性分析2016年12月~2018年12月我科58例中耳胆脂瘤患者采用耳内镜下经外耳道入路鼓室探查术+鼓室成形术+/-改良乳突根治术,观察术后3个月鼓膜愈合率,比较术前及术后3... 目的探讨耳内镜下经耳道入路中耳胆脂瘤手术的可行性及疗效。方法回顾性分析2016年12月~2018年12月我科58例中耳胆脂瘤患者采用耳内镜下经外耳道入路鼓室探查术+鼓室成形术+/-改良乳突根治术,观察术后3个月鼓膜愈合率,比较术前及术后3个月平均气导听阈及气骨导差。结果 58例患者术后3 个月鼓膜愈合56例(占96.55%),因感染继发性穿孔2例(占3.45%),均在门诊耳内镜下处理后完全愈合。58例患者术前平均气导听阈(49.02±20.06)dB HL,术后3个月平均气导听阈(35.58±15.68)dB HL,两者比较差异有统计学意义(t =5.65,P<0.05)。58例患者术前平均气骨导差(34.40±28.10)dB HL,术后3个月平均气骨导差(18.32±10.63)dB HL,两者比较差异有统计学意义(t =13.10,P<0.05)。术后无1例严重感音神经性聋,无面瘫及眩晕并发症。结论 耳内镜下经外耳道入路中耳胆脂瘤手术具有可行性高、手术时间较短、术中出血量少、术后干耳时间短、术后鼓膜愈合率高、听力改善效果良好、并发症少等优点。 展开更多
关键词 耳外科手术 内窥镜检查 胆脂瘤 中耳 鼓室成形术
腔镜下经乳晕入路切除术与低位领式切口切除术治疗甲状腺肿瘤效果比较 预览
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作者 刘宜 齐庆安 +2 位作者 张晓辉 王锦波 卢文献 《实用医药杂志》 2019年第7期600-603,共4页
目的比较腔镜下经乳晕入路甲状腺肿瘤切除与低位领式切口甲状腺肿瘤切除的疗效。方法对2014年6月—2017年8月随机抽取笔者所在医院收治100例甲状腺肿瘤患者的临床资料行回顾性分析,低位领式切口甲状腺肿瘤切除50例作为对照组(A组),腔镜... 目的比较腔镜下经乳晕入路甲状腺肿瘤切除与低位领式切口甲状腺肿瘤切除的疗效。方法对2014年6月—2017年8月随机抽取笔者所在医院收治100例甲状腺肿瘤患者的临床资料行回顾性分析,低位领式切口甲状腺肿瘤切除50例作为对照组(A组),腔镜下经乳晕入路行甲状腺肿瘤切除50例为观察组(B组),比较两组患者围手术期观察指标及美容效果。结果观察组较对照组在手术时间、术中出血量、术后引流量、住院时间及切口长度优势明显,差异有统计学意义(P<0.05)。观察组与对照组在吞咽不适、皮肤感觉异常、神经损伤、手足抽搐两组比较,差异无统计学意义(P>0.05)。观察组美容效果较对照组明显,差异有统计学意义(P<0.05)。结论腔镜下经乳晕入路甲状腺肿瘤切除术较传统手术具有极佳的美容效果,切口小、恢复快、安全可靠等优点,值得临床推广应用。 展开更多
关键词 腔镜 甲状腺肿瘤 甲状腺切除术 乳晕径路 疗效
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耳内镜手术治疗先天性听骨链畸形效果分析
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作者 陈越勃 郑亿庆 +2 位作者 冯天赐 顾庆于 杨海弟 《中国耳鼻咽喉头颈外科》 CSCD 2019年第7期350-353,共4页
目的对比耳内镜手术与显微镜手术对听骨链畸形患者的治疗效果,明确耳内镜手术是否是听骨链畸形治疗的有效手段。方法 回顾听骨链畸形患者16例,进行耳内镜手术共8例(10耳),为耳内镜组,进行显微镜手术8例(9耳),为显微镜组,对比两组的手术... 目的对比耳内镜手术与显微镜手术对听骨链畸形患者的治疗效果,明确耳内镜手术是否是听骨链畸形治疗的有效手段。方法 回顾听骨链畸形患者16例,进行耳内镜手术共8例(10耳),为耳内镜组,进行显微镜手术8例(9耳),为显微镜组,对比两组的手术时间、术后住院天数及术后听力学改善情况。结果 耳内镜组的手术时间、年龄与显微镜组均没有统计学差异。耳内镜组住院天数(3.4±1.64)天,显微镜组住院天数(5.2±0.6)天,两组比较差异有统计学意义(t=3.093,P=0.007)。耳内镜组和显微镜组术后气导听阈均较术前明显减低(Z=3.292,P=0.001;Z=3.403,P=0.001),骨导听阈改变无统计学差异(Z=0.038,P=0.97;Z=0.489,P=0.625)。两组的气骨导差变化值差异无统计学意义(Z=1.800,P=0.079)。结论 耳内镜手术对听骨链畸形的治疗效果与显微镜手术效果相当,是听骨链畸形患者诊断和治疗的有效选择,但耳内镜手术要求术者熟悉局部解剖结构,能熟练进行单手操作。 展开更多
关键词 耳外科手术 内窥镜检查 听小骨
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