电子线阵式超声胃镜在上消化道及其临近脏器疾病中的诊疗应用  

Application of electronic linear scanning echogastroscopy in the diagnosis and therapy of upper gastrointestinal and its adjacent lesions

作　　者：占强[1] 郭继中[1] 夏敏[1] 王含芬[1] 王辉[1] 朱德坤[1] 严洁[1] 

机构地区：[1]南京医科大学附属无锡第一医院消化病科,无锡214002

出　　处：《江苏医药》2007年第8期781-783,共3页Jiangsu Medical Journal

基　　金：南京医科大学科技发展基金(NY04061)

摘　　要：目的探讨电子线阵式超声胃镜(EUS)在上消化道及其临近脏器疾病中诊疗应用的临床价值。方法采用PENTAXEG-3630U型电子线阵式超声胃镜对121例上消化道及其临近脏器疾病患者进行常规线阵式内镜超声检查,并对13例上消化道黏膜下隆起病变和胰腺疾病患者行内镜超声引导下细针吸取细胞学检查(EUS-FNA),4例晚期胰腺癌和胆管癌合并顽固性腹痛患者行内镜超声引导下腹腔神经丛阻滞(EUS-CPN)和1例腹腔内囊性肿块穿刺抽液。结果121例患者中,上消化道黏膜下隆起病变60例(49.6%),上消化道黏膜良性病变8例(6.6%),食管、胃恶性肿瘤9例(7.4%),肿瘤转移性淋巴结肿大3例(2.5%),胆胰病变27例(22.3%),十二指肠乳头癌2例(1.7%),十二指肠乳头腺瘤1例(0.8%),左肾上腺良性增生病变1例(0.8%),正常结构10例(8.3%)。13例行EUS-FNA的患者中10例取材成功可以进行病理诊断(76.9%),4例行EUS-CPN患者中3例治疗有效。结论电子线阵式超声胃镜对上消化道及其临近脏器疾病有重要的诊断和治疗应用价值。Objective To explore the clinical value of electronic linear scanning echogastroscopy in the diagnosis and therapy of upper gastrointestinal and its adjacent lesions. Methods Regular linear scanning endoscopic ultrasonography （EUS） was performed in 121 cases of upper gastrointestinal and its adjacent lesions by PENTAX EG-S630U echogastroscopy. Endoscopic ultrasonography guided fine needle aspiration （EUS-FNA） was performed in 13 cases of upper gastrointestinal submucosal leision and pancreatic disease. Endoscopic ultrasonography guided celiac plexus neurolysis（EUS-CPN） was carried out in 4 cases of advanced pancreatic cancer and bile duct cancer complicated with refractory abdominal pain. Endoscopic ultrasonography guided intraperitoneal puncture was done in 1 case of intraperitoneal cyst to draw the cystic fluid. Results Of 121 patients examined with EUS, upper gastrointestinal submucosal leision was diagnosed in 60 cases （ 49.6 %）, upper gastrointestinal benign mucosal lesion in 8 cases（6.6 %）, gastroesophogeal malignant tumor in 9 cases（7.4%） ,metastastic lymph node of tumor in 3 cases（2. 5%）, bile and pancreatic diseases in 27 cases（22.3%）, duodenal papillary cancer in 2 cases（1.7%）,duodenal papillary adenoma in 1 cases （0. 8%） ,benign proliferative lesion of left adrenal gland in 10 cases（0. 8%） and normal structure in 10 cases（8. 3%）. Biopsy specimens enough for pathological diagnosis were acquired in 10 of 13 EUS-FNA（76.9%） patients. The treatment of EUS-CPN was effective in 3 of 4 cases of advanced cancer. Conclusion Electronic linear scanning echogastroscopy has important clinical value in the diagnosis and therapy of upper gastrointestinal and its adjacent lesions.

关 键 词：超声胃镜 细针穿刺 腹腔神经丛阻滞 

分 类 号：R573[医药卫生—消化系统]