胃镜联合钡剂造影检查在胃癌患者临床诊断中的应用及评价

目的：探讨胃镜检查联合钡剂造影在胃癌患者临床诊断中的应用价值，为正确指导胃癌患者手术方式的选择提供临床依据。方法选择2011年4月至2012年4月期间我院收治的178例胃癌患者为研究对象，随机对照组和研究组，对照组患者单纯进行胃镜检查，研究组患者给予胃镜联合钡剂造影检查，比较两种检查方法对患者肿瘤大小、位置的诊断结果。结果两种检查方法对患者肿瘤大小、位置的诊断正确率比较无显著性差异（P ＞0．05）。单纯胃镜检查对贲门癌患者食管浸润长度的判断准确率为53．85％（7/13），胃镜联合钡剂造影检查的判断准确率为94．12％（16/17），差异有显著性（χ2＝6．679，P ＝0．025＜0．05）。经胃镜检查预测手术入路相符率为50．00％（9/18），经胃镜联合钡剂造影检查预测手术入路相符率为84．21％（16/19），差异有显著性（χ2＝4．937，P ＝0．038＜0．05）。结论胃镜联合钡剂造影检查对胃癌患者具有较高的诊断价值，能够明确贲门癌患者食管受累长度，对手术入路的选择准确，值得临床推广。

Diagnosis Value of Castroscopy Plus Barium Contrast Examination in Gastric Cancer

Objective To study diagnosis value of castroscopy plus barium contrast examination in gastric cancer, and to provide clinical basis for the operative planning in gastric cance.Methods 178 patients with gastric cance were randomly divided into two groups.The control group was treated by pure gastroscopy,and the research group was treated by castroscopy combined barium contrast examination.The diagnostic results of tumor size and location of the two methods were compared.Results The diagnostic accuracy of tumor size and location of the two groups had no sig-nificantly difference （P 〉0.05）.Diagnostic accuracy of esophagus infiltrating length of cardiac cancer patients of con-trol group was 53.85%（7/13）,was significantly lower than 94.12%（16/17）in research group （χ2 = 6.679 and P =0.025〈0.05）.Surgical approach predictions corresponding rate of control group was 50.00%（9/18）,was obviously lower than 84.21% （16/19）in research group（χ2 =4.937 and P =0.038〈0.05）.Conclusion It is necessary to per-form 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 thoraeotomy.It is worth of clinical promotion.