窄带成像及放大胃镜观察胃小凹形态改变对胃黏膜病变诊断价值的研究

摘要

Objective To understand the status of MRSA carrying among health care workers and patients, and the environment in high - risk wards of a hospital and to explore prevention and control strategies of noso-comial MRSA infection. Methods Samples from the medical staff, the patients and environment in 7 high -risk wards of a hospital,were cultured. MRSA strains were identified by the CLSI standarded cefoxitin (FOX) KB method. Results In samples from 713 health care workers and the environment, 41 (5. 75% ) strains of SA were found including MRSA 11 strains(26. 83% ). In samples from 639 patients and the environment, the detection rate of SA were 10.49% including 43 strains of MRSA( 64.18% ). Conclusion It is critical to a-ware the situation of MRSA carrying in medical staff, patients and ward environment. We should improve hand hygiene compliance, strict implementation of sterile operating procedures and strengthen the management and training of cleaning staff to ensure effective environmental cleaning and disinfection.%目的 研究窄带成像及放大内镜(narrow- band imaging system with magnifying endoscopy,NBI - ME)下胃小凹形态改变对诊断胃黏膜病变及早期胃癌的价值.方法 对112例常规胃镜检查发现有局部胃黏膜病变(糜烂、颜色异常、隆起、浅凹陷、粗糙等)的患者,NBI - ME模式观察胃小凹形态,参照Tanaka分型对病变进行判断,同时病变区域取活检进行病理检查.结果 窄带成像及放大胃镜观察胃小凹形态改变诊断癌前病变(中-重度肠化、轻-中度异型增生)检出率为39.2％ (44/112),诊断早期胃癌的检出率为42.3％(11/26)；胃黏膜病变NBI - ME诊断癌前病变(中-重度肠化、轻-中度异型增生)的灵敏度为72.7％,特异度为77.9％,符合率为75.8％；诊断早期胃癌的灵敏度为81.8％,特异度为96.0％,符合率为94.6％.结论 窄带成像及放大胃镜观察胃小凹形态能够提高癌前病变及早期胃癌的诊断率.