微探头超声内镜在胃平滑肌瘤诊断中的应用价值  

Application Value of Miniprobe Endoseopic Ultrasonography in the Diagnosis of Gastric Leiomyoma

作　　者：朱艳丽[1] 崔颖[1] 孙绍杰[1] 王艳凤[1] 冯秀娟[1] 任秀英[1] 宋文玲[1] 耿佳颖[1] 刘亮 

机构地区：[1]黑龙江省佳木斯大学附属第一医院,佳木斯市154003 [2]黑龙江省佳木斯市肿瘤医院

出　　处：《中国病案》2012年第5期73-75,共3页Chinese Medical Record

摘　　要：目的探讨微探头超声内镜(miniprobe endoscopic ultrasonography MEUS)在胃平滑肌瘤诊断中的应用价值。方法对125例胃黏膜下隆起性病变行微探头超声内镜检查,在MEUS检查前均经胃镜检查并发现胃内有隆起性病变,但诊断未能确定。对76例MEUS诊断为胃平滑肌瘤的病例均行内镜下治疗,术后标本送病理检查。将胃镜、MEUS及病理结果进行比较。结果超声内镜诊断胃平滑肌瘤76例,其中病变起源于黏膜肌层62例,给予内镜下黏膜下切除术治疗;起源于固有肌层14例,给予内镜下黏膜下剥离术治疗。病变位于胃底部14例,胃体部28例,胃窦部34例;直径<2cm 64例,>2cm 12例。76例患者均成功切除病变,7.5MHZ适合于显示病灶内部回声,12MHZ显示病灶起源较清楚。病理均提示为胃平滑肌瘤,其起源层次与超声内镜诊断结果一致,超声内镜检查准确率为100%。结论微探头超声内镜可清晰显示胃平滑肌瘤的病变层次结构,根据其诊断结果对胃平滑肌瘤行内镜下治疗是一种安全、有效、创伤小的治疗方法。Objectives This paper studies the application value of miniprobe endoscopic ultrasonography in the diagnosis of gastric leiomyoma.Methods 125 patients who were diagnosed protrusion lesion in stomach by gastroscopy.76 patients were diagnosed gastric leiomyoma by using miniprobe endoscopic ultrasonography which was treated by using endoscopic submucosa resection（EMR） or endoscopic submucosa dissection（ESD）.After treatment the specimens were checked by pathology and compared with the result of MEUS and gastroscope.Results Totally Seventy-six cases are all proved gastric leiomyomas by MEUS,62 from muscularis mucosa were treated by endoscopic mucosal resection（EMR）;14 from muscle layer were treated by endoscopic submucosal disseetion（ESD）.Lesion locate in bottom of stomach are 14 cases,28 cases in the body of stomach and 34 cases in gastric antrum;64 cases of diameter less than 2cm and 12 cases of diameter larger than 2cm.76 patients had success lesion excision;7.5MHZ suitable for lesion internal echo and 12MHZ suitable for clear source of lesion.They are all proved gastric leiomyomas by pathology,whose original layer is the same with the diagnosis of MEUS.The accurate of endoscopic ultrasonography was 100%.Conclusion Different layers of stomach with protrusion lesion can be distinguished clearly by MEUS.It is an effective and safe with little trauma method that endoseopic therapy of gastric leiomyoma according the result of miniprobe endoscopic ultrasound.

关 键 词：微探头超声内镜 胃平滑肌瘤 内镜下诊断 

分 类 号：R735.2[医药卫生—肿瘤]