目的: 探讨电子纤维喉镜在喉咽部白光和窄带成像( Narrow Band Imaging，NBI) 联合放大内镜下显
示病变性质术前手术方式和范围的预估和术后病理证实研究。方法: 对203 例喉咽病变病人术前进行NBI 模式
联合放大内镜鉴别检查，观察病变黏膜的形态特征和黏膜周围浅血管的病变在NBI 模式进行血管特点观察。结
果: 病人术前、病理、术后1mo 进行分析喉部良性病变、低级别、高级别上皮内瘤变以及早期喉癌的诊断结果中发
现术前NBI 模式预估病理类型与术前取活检和术后石蜡病理准确率为93．7%。结论: 喉咽部病变NBI 模式电子
喉镜术前检查病变组织可精确预判术中手术范围尽可能减少损伤喉部正常组织，同时NBI 技术能提高高级别上
皮内瘤变、早期喉癌病人的检出率。尽早尽量恢复病人发音、吞咽功能。

Objective: To evaluate the value of narrow band imaging( NBI) endoscopy and ordinary
endoscopy in the diagnosis and analyze of laryngeal lesions．Methods: Between January 2013 and May
2016，a total of 203 patients with laryngeal lesions were examined with electronic laryngoscope
equipped with the white light mode and NBI mode， the biopsies of laryngeal lesions were done in early
lesions patients．The characteristics of morphologies of mucosa and mucosal superficial vessels of each
lesion with white light mode after NBI mode were evaluated．Patients were studied the clinical observation
and analysis，which were comparison in preoperative and postoperative pathology after in 1month．
Results: It was accuracy of 93．7%that preoperative forecast pathological type and pathological of all cases．
Conclusion: NBI has a potential ability to predict pathological results of laryngeal lesions and decreased
to hurt normal mucosa．It is important that were found at early period of lesions，which were accurate．
Electronic nasopharyngolaryngoscope of NBI can observe vessel of laryngeal mucosa，the
detective ratio of laryngeal lesion can be improved and omission diagnostic rate can be reduced
damage， the vascular pattern is useful in diagnosing laryngeal carcinoma and precancerous lesions．It is
possible keep normal tissue structure of the larynx，which can keep pronunciation， swallowing function
for recoveried in surgery．

R767．04

 收稿日期: 2017－02－22; 修回日期: 2017－06－03
基金项目: 内蒙古自治区人民医院院内基金项目( 201543)
作者简介: 韩剑锋( 1971－) ，男，内蒙古自治区人民医院耳鼻咽喉头颈外科副主任医师。