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1、授予單位代碼10089學(xué)號(hào)或申請(qǐng)?zhí)?5294中國(guó)圖書(shū)分類號(hào)R573.9HebeiMedicalUniversity碩士學(xué)位論文學(xué)術(shù)學(xué)位殘胃癌前病變及早期癌內(nèi)鏡下診斷治療與臨床分析研究生：馬晶晶導(dǎo)師：張立瑋教授專業(yè)：內(nèi)科學(xué)二級(jí)學(xué)院：第四醫(yī)院2018年3月目錄中文摘要·································································································1英文摘要···························································
2、······································5英文縮寫(xiě)·································································································11研究論文殘胃癌前病變及早期癌內(nèi)鏡下診斷治療與臨床分析前言·································································································12材料與方法···················
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4、····················································································21討論·································································································25結(jié)論·································································································32參考文獻(xiàn)·
5、································································································32綜述內(nèi)鏡在殘胃癌早期診治中的應(yīng)用現(xiàn)狀及進(jìn)展······························35致謝·································································································46個(gè)人簡(jiǎn)歷·····································
6、····························································47殘胃癌前病變及早期癌內(nèi)鏡下診斷治療與臨床分析摘要背景：殘胃是指胃、十二指腸良性或惡性疾病做胃切除術(shù)后的殘余部分。胃術(shù)后因生理解剖結(jié)構(gòu)的破壞，致使患者易出現(xiàn)諸如殘胃炎、殘胃潰瘍，甚至殘胃癌等并發(fā)癥。隨著醫(yī)學(xué)知識(shí)的普及，人們認(rèn)識(shí)到殘胃本身即是一種癌前病變。也有學(xué)者表示，發(fā)生殘胃癌是胃術(shù)后的必然規(guī)律，胃大部切除患者術(shù)后長(zhǎng)期生存就有發(fā)生病變的可能。因此如何早期發(fā)現(xiàn)殘胃病變、殘胃早期癌并及時(shí)治療，對(duì)提高殘胃患者生存期尤關(guān)重要。目前殘胃患者通常以CT、超聲、內(nèi)鏡等檢查及
7、血清學(xué)檢驗(yàn)作為復(fù)查的選擇項(xiàng)目。在諸多檢查手段中，胃鏡檢查是觀察上消化道粘膜層病變的唯一方法，具有直視下完善病理活組織檢查的優(yōu)勢(shì)，同時(shí)合理有效的內(nèi)鏡隨訪亦是早期發(fā)現(xiàn)殘胃癌前病變及早期癌的重要手段。殘胃癌失去再次手術(shù)患者可通過(guò)內(nèi)鏡下治療達(dá)到提高總體胃癌生存率的目的；早期殘胃癌患者，可通過(guò)微創(chuàng)治療使殘胃病變干預(yù)治療更及時(shí)、有效，降低殘胃癌的發(fā)生。目的：本研究重點(diǎn)探討了殘胃癌前病變及早期癌與病程時(shí)限、部位、術(shù)式間相關(guān)性；分析了內(nèi)鏡下殘胃癌前病變及早期癌形態(tài)特點(diǎn)及規(guī)律；了解殘胃重度異型增生
