微超声探头对大肠黏膜下肿瘤的诊疗价值  

Application of endoscopic miniprobe ultrasonography in diagnosis and therapy of gastrointestinal submucosal tumors

作　　者：姜利佳[1] 朱丽明[1] 陈利民[1] 

机构地区：[1]浙江省温州市第二人民医院消化科,325000

出　　处：《中国医师进修杂志（内科版）》2008年第7期17-19,共3页Chinese Journal of Postgraduates of Medicine

摘　　要：目的探讨经内镜微超声探头检查大肠黏膜下肿瘤的诊断及治疗价值。方法应用微超声探头对大肠黏膜下肿瘤进行肠镜下超声检查，根据其起源层次及性质决定治疗方案。结果20例结直肠黏膜下肿瘤中，间质瘤9例，脂肪瘤5例，类癌3例，肠间壁脓肿2例，肠气囊肿症1例。4例源于黏膜肌层的良性间质瘤及2例类癌经内镜切除，2例肠间壁脓肿及1例肠气囊肿症行内镜下穿刺治疗；3例源于固有肌层的良性间质瘤、2例恶性间质瘤、2例脂肪瘤、1例类癌，经手术切除。病理符合率为88．24％。其余3例脂肪瘤则内镜随访。结论超声内镜能够对消化道黏膜下肿瘤进行起源和定性诊断，对黏膜下肿瘤治疗方案的选择具有重要的指导意义。Objective To evaluate the diagnostic value of endoscopic minipmbe ultrasonography （MPS） and endoscopic therapies under the guidance of MPS in gastrointestinal submucosal tumors. Methods Patients with submucosal tumors of lower digestive tract were given MPS under colonoscope. Endoscopic therapy or surgery had been taken according to different deriving layers of submucosal tumors. The ultimate diagnosis was confirmed by histology. Results Twenty patients with submucosal tumors were diagnosed with MPS under colonoscope, including 9 patients with stromal tumors, 5 patients with lipoma, 3 patients with carcinoid, 2 patients with abscess,1 patient with intestines pneumatosis. Four patients with benign stromal tumors derived from muscularis mucosa and 2 patients with carcinoid were resected by endoscopy. Two patients with abscess and 1 patient with intestines pneumatosis were puncture under endoscopy. Three patients with benign stromal tumors from muscularis propria, 2 patients with malignant stromal tumors, 2 patients with lipoma and 1 patient with carcinoid were resected surgically. 88.24% submucosal tumors diagnosed by MPS were identified by pathology. Three cases were followed-up by endoscopy. Conclusions Different layers of gastrointestinal tract with submucosal tumors can be distinguished clearly by MPS leading to definite diagnosis of submucosal tumors. MPS can play an important role in selecting treatment procedures.

关 键 词：腔内超声检查 诊断 治疗 肿瘤 黏膜下 

分 类 号：R735[医药卫生—肿瘤] R735.34[医药卫生—临床医学]