小探头超声内镜在诊治大肠黏膜隆起性病变中的价值  

The Value of Miniprobe Ultrasonography in Diagnosis and Treatment of Protrusion Lesion in Large Intestine Mucous Membranel

作　　者：周明东[1,2] 仝巧云[1,2] 袁晋华[1,2] 李中艳[1,2] 覃丽华[1,2] 莫莉花[1,2] 

机构地区：[1]三峡大学第一临床医学院,湖北宜昌443003 [2]宜昌市中心人民医院消化内科,湖北宜昌443003

出　　处：《现代生物医学进展》2012年第29期5705-5707,共3页Progress in Modern Biomedicine

摘　　要：目的:探讨小探头超声内镜(miniprobe ultrasonography,MPS)在诊断及治疗大肠黏膜隆起性病变中的价值。方法:对经常规内镜检查提示的大肠黏膜隆起性病变患者行小探头超声内镜检查,了解病变的性质及来源,然后行针对性治疗。结果:2009年5月～2011年5月共54例患者,其中直肠25例,结肠22例,盲肠7例。根据小探头超声内镜检查结果,对其中44例黏膜隆起性病变根据病变大小及深度分别行圈套器高频电切除术、内镜黏膜切除术(endoscopic mucosal resection,EMR)或内镜黏膜下层剥离术(endoscopic submucosaldissection,ESD)等内镜下治疗,其中除结肠、盲肠囊肿及气囊肿5例外,余均送检病理,结肠、盲肠脂肪瘤6例,直肠类癌5例,大肠息肉28例,其中幼年性息肉2例,腺瘤18例,增生性息肉4例,炎性息肉4例;5例来源于固有肌层的间质瘤,其中3例直径小于1 cm的患者要求观察随访,2例行外科手术治疗,其中1例直肠巨大黏膜隆起病变小探头超声内镜来源显示不清,改为环形扫描超声内镜确定来源后再行外科手术治疗,结果均证明确实为来源于固有肌层的间质瘤;1例直肠淋巴瘤行外科手术治疗,超声内镜、内镜后病理及手术后病理均得到证实;还有2例肠腔外压迫,2例手术后改变。结论:小探头超声内镜能清楚显示消化道壁的层次及结构,对大肠黏膜隆起性病变的起源具有准确的定位作用,并能够提示病变的性质,对进一步的治疗有指导意义。ABSTRACT Objective： To investigate the value of miniprobe ultrasonography in diagnosis and treatment of protrusion lesion in large intestine mucous membrane. Methods： We took miniprobe ultrasonography for the protrusion lesion in large intestine mucous membrane which were diagnosed by common endoscopy, and then got the message of the charater and source of the lesion to treat it. Results： From May of 2009 to May of2011, there were 54 patients including 25 rectum, 22 colon and 7 cecum who accepted miniprobe ultrasonography. We took snare electrosection, endoscopic mucosal resection or endoscopic submucosaldissection based on the size and depth of the lesion by the miniprobe ultrasonography. According to the pathology, there were 6 patients for colon or rectum lipoma, 5 for rectum carcinoid, 28 for large intestine polyps which including 2 juvenile polyps, 18 adenomas, 4 hyperplastic polyps, 4 inflammatory polyps. There were 5 interstitislomas in the muscularis propria. 3 patients of them asked for observation and follow up. 2 patients were cured by surgery. There was 1 patient for lymphoma and was cured by surgery. There were 2 patients for oppression outside intestines and 2 for changes after operation. Key words： Miniprobe ultrasonography; Protrusion lesion in large intestine mucous membrane; Diagnose; Treatment

关 键 词：小探头超声内镜 大肠黏膜隆起性病变 诊断 治疗 

分 类 号：R574.6[医药卫生—消化系统]