残胃癌前病变及早期癌内镜下诊断治疗与临床分析

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1、授予单位代码10089学号或申请号15294中国图书分类号R573.9HebeiMedicalUniversity硕士学位论文学术学位残胃癌前病变及早期癌内镜下诊断治疗与临床分析研究生：马晶晶导师：张立玮教授专业：内科学二级学院：第四医院2018年3月目录中文摘要·································································································1英文摘要···························································

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5、································································································32综述内镜在残胃癌早期诊治中的应用现状及进展······························35致谢·································································································46个人简历·····································

6、····························································47残胃癌前病变及早期癌内镜下诊断治疗与临床分析摘要背景：残胃是指胃、十二指肠良性或恶性疾病做胃切除术后的残余部分。胃术后因生理解剖结构的破坏，致使患者易出现诸如残胃炎、残胃溃疡，甚至残胃癌等并发症。随着医学知识的普及，人们认识到残胃本身即是一种癌前病变。也有学者表示，发生残胃癌是胃术后的必然规律，胃大部切除患者术后长期生存就有发生病变的可能。因此如何早期发现残胃病变、残胃早期癌并及时治疗，对提高残胃患者生存期尤关重要。目前残胃患者通常以CT、超声、内镜等检查及

7、血清学检验作为复查的选择项目。在诸多检查手段中，胃镜检查是观察上消化道粘膜层病变的唯一方法，具有直视下完善病理活组织检查的优势，同时合理有效的内镜随访亦是早期发现残胃癌前病变及早期癌的重要手段。残胃癌失去再次手术患者可通过内镜下治疗达到提高总体胃癌生存率的目的；早期残胃癌患者，可通过微创治疗使残胃病变干预治疗更及时、有效，降低残胃癌的发生。目的：本研究重点探讨了残胃癌前病变及早期癌与病程时限、部位、术式间相关性；分析了内镜下残胃癌前病变及早期癌形态特点及规律；了解残胃重度异型增生