超声内镜联合内镜下黏膜切除术治疗黏膜及黏膜下病变的临床分析  

Clinical analysis on endoscopic mucosal resection with guided endoscopic ultrasonography for treating mucosal-submucosal gastrointestinal tract lesion

作　　者：沈小春[1] 王军[1] 胡辂[1] 周世亮[1] 刘宇[1] 李平[1] 闫庆军[1] 曹燕[1] 兰春慧[1] 

机构地区：[1]第三军医大学大坪医院消化内科,重庆400042

出　　处：《重庆医学》2011年第14期1391-1392,1394,共3页Chongqing medicine

摘　　要：目的总结超声内镜联合内镜下黏膜切除术(EMR)治疗消化道黏膜及黏膜下病变的临床价值。方法 52例共70处消化道黏膜及黏膜下病变,用超声内镜检查明确病变起源层次,生长特性和性质,再以注射法或透明帽辅助法行黏膜切除治疗,记录其操作方法、并发症、术后病理类型及随访情况。结果 70处病变经EMR或内镜下黏膜分片切除术(EPMR)完整切除,治愈率98.12%。术中出血1例,并发症发生率1.42%。术后病理提示,良性腺瘤12例,黏膜肌层平滑肌瘤15例,乳头状瘤3例,囊肿5例,脂肪瘤4例,间质瘤8例,异位胰腺4例,类癌1例,增生性和炎性息肉16例,早癌2例,与超声内镜的诊断符合率达88.57%。结论超声内镜检查指导下对起源于消化道黏膜及黏膜下病变采用内镜下黏膜切除术是一项安全有效的微创治疗方法。Objective To investigate the effect of endoscopic treatiing mucosal resection and endoscopic piecemeal mucosal resection for treating mucosal-submucosal gastrointestinal tract lesions.Methods A total of 52 patients with 70 lesions were included in this study and all subjected to endoscopic ultrasonography（EUS）.EMR and EPMR were performed by means of injection snare cut method or transparent cap-fitted endoscope.The method of operation,rates of complications and follow-up investigation were recorded.All resected specimens were retrieved for pathological study.Results 70 lesions were removed completely by EMR or EPMR.The curative rate was 98.12%.There were 5 cases with bleeding and useing APC and titanium clips to stop bleeding.No perforation occurred.The pathological finding were as follows：12 lesions of benign adenomas,15 lesions of leiomyomas,3 lesions of papillary epithelioma,5 lesions of cyst,4 lesions of liparomphalus,8 lesions of stromal tumors,4 lesions of ectopic pancreas,1 lesions of carcinoid,16 lesions of hyperplastic and inflammatory polyp,2 cases of early cancer.The rate of pathological consistent with EUS was 88.5%.Conclusion EUS is able to determine the initial source and level of gastrointestinal superficial protuberances,and EUS guided EMR is a safe and effective technique for the treatment of mucosalsubmucosal gastrointestinal tract lesions.

关 键 词：腔内超声检查 内镜下黏膜切除术 消化道黏膜及黏膜下病变 病理 

分 类 号：R57[医药卫生—消化系统]