微型探头超声内镜在上消化道黏膜下肿瘤诊断和治疗中的价值  

The Value of Miniature Probe Endoscopic Ultrasonography in the Diagnosis and Therapy of Submucosal Tumors of Upper Gastrointetinal Tract

作　　者：陈进忠[1] 苏虹[1] 李宝玉[1] 廖素珠[1] 苏雪芬[1] 李秀梅[1] 

机构地区：[1]福建医科大学附属厦门第一医院消化科内镜室,福建厦门361003

出　　处：《中国临床医学》2008年第5期633-635,共3页Chinese Journal of Clinical Medicine

摘　　要：目的:探讨微型探头超声内镜(mEUS)在上消化道黏膜下肿瘤的诊断和治疗中的作用。方法:对87例疑为上消化道黏膜下肿瘤的患者进行微型探头超声内镜检查,根据黏膜下肿瘤的起源层次,部分患者接受內镜下治疗或外科手术?峁?mEUS检查的87例患者中,发现消化道壁外压迫5例(其中主动脉弓2例,脾脏1例,胆囊及肝左叶各1例);粘膜下肿瘤82例,包括平滑肌瘤45例,良性间质瘤17例,恶性间质瘤6例,脂肪瘤4例,静脉瘤3例,异位胰腺4例,囊肿3例。19例起源于粘膜肌层的平滑肌瘤行高频电切除术切除,3例静脉瘤行尼龙圈套结扎,4例脂肪瘤及3例囊肿行高频电切除。5例恶性间质瘤行手术治疗。1例平滑肌瘤,切除后病理诊断为恶性间质瘤,其余的病理诊断与超声诊断相符。结论:mEUS检查能清楚显示上消化道黏膜下肿瘤的大小,起源层次、生长方向及邻近组织结构关系,较准确地判断肿瘤的性质,进而指导黏膜下肿瘤治疗方案的选择。Objective：To assess the value of miniature probe endoscopic ultrasonography（mEUS） in the diagnosis and treatment of submucosal tumors（SMTs） of upper gastrointestinal tract. Methods： 87 patients with suspected SMTs were examined by EUS with mEUS（Olympus UM-3R, 20MHz; UM 2R, 12MHz）,some of which were subjected to endoscopic therapy or surgery operation according to the different deriving layers of SMTs. Results： 5 protuberances from outside organ（aorta,u = 2; spleen, n = l ; gallblader, n = 1 ;left hepatic lobe, n = 1 ） and 82 SMTs were detected by mEUS including 45 leiomyomas（esophageal, n = 38 ; gastric, n = 7）, 17 benign stromal tumours, 6 malignent stromal tumours in stomach, 4 lipomas（ esophageal, n = 1 ; gastric,n = 3）,3 varices in gastric fundus,4 etopic pacreaces in stomach,3 cysts in duodenum. 19 leiomyomas derived from muscularis mucosa,4 lipomas and 3 cysts derived from submucosa were resected by endoscopic snare cauterization. 3 varices in fundus were treated by nylon ligation. 5 malignent stromal tumours were resected surgically. Of which 30were identified by pathology except 1 malignent stromal tumour was misdiagnosed as leiomyoma by EUS. Conclusion： The size, layer of origin , border of GI SMTs can be distinguished clearly by mEUS,leading to definite diagnosis of SMT. EUS is important in the choice of therapy for SMTs and shoud routinely be performed on all suspected SMTs prior to attempt at removel.

关 键 词：微型探头超声内镜 黏膜下肿瘤 诊断 治疗 

分 类 号：R730.4[医药卫生—肿瘤]