从内镜上正常的末端结核进行活检是必要的吗?
Haily Vora1, Ramez Ibrahim1, Johanna Chan1
1Division of Gastroenterology and Hepatology, Mayo Clinic in Florida, Jacksonville, FL, USA (Haily Vora, Ramez Ibrahim, Johanna Chan, Francis A. Farraye, Jana G. Hashash).
在结肠镜检查过程中对一个看起来正常的末端大肠骨进行活检,很少会发现重大问题. 这些活检具有有限的诊断和治疗价值,这表明慢性腹患者可能不需要例行采样.
科学领域:
- 胃肠病学 胃肠病学
- 组织病理学 组织病理学
- 临床医学 临床医学
背景情况:
- 在结肠镜检查期间,终端结肠通常会被检查,特别是在炎症性肠病 (IBD) 和腹的患者中.
- 从内镜上正常的末端大肠骨中进行活检的临床效用是不确定的,可能会增加成本和医疗保健利用率.
研究的目的:
- 为了确定活检结果是否从内镜上正常的末端结核影响临床管理.
- 在这个患者群体中评估例行活检的诊断和治疗效用.
主要方法:
- 对接受终端结核活检的结核结核镜检查的患者的回顾性图表审查.
- 排除患有IBD的患者,之前的乳房切除,或异常的内镜检测结果.
- 从电子医疗记录中收集的数据;使用Pearson的千平方测试进行统计比较.
主要成果:
- 确诊了1018名患者;299人符合纳入标准.
- 在4.3% (13/299) 的患者中发生异常活检.
- 组织学异常包括慢性脑膜炎,急性脑膜炎和粉样蛋白沉积,主要发生在慢性腹患者中.
结论:
- 临床上显著的组织学异常在内镜正常的末端大肠的活检中很少见.
- 常规活组织检查看起来正常的终端结膜具有有限的诊断和治疗效用.
- 研究结果表明,例行活检可能不具有成本效益或临床益处.
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