67例胃肠道间质瘤患者的内镜诊断和治疗  

Diagnosis and treatment with endoscopy in gastrointestinal stromal tumors

作　　者：刘军[1] 罗和生[1] 崔凝[1] 

机构地区：[1]武汉大学人民医院消化内科,430064

出　　处：《临床内科杂志》2012年第11期736-738,共3页Journal of Clinical Internal Medicine

摘　　要：目的探讨胃肠道间质瘤的内镜下特点及内镜治疗方式。方法回顾性分析2004年1月～2011年6月间我院67例胃肠道间质瘤患者的临床及其病理资料，统计患者的临床表现、辅助检查及治疗等。辅助检查方法包括内镜（超声内镜）或影像学检查（CT平扫及增强），治疗方法为内镜下治疗或外科手术治疗。结果胃肠道间质瘤男女发病率相似，以中老年患者居多，45岁以上者55例（82．1％）。病程长短不等，以黑便，血便（27例，40．3％）、腹痛（18例，26．9％）、腹部不适（8例，11．9％）等非特异性症状为主。病变部位位于胃（38．8％）及小肠（40．3％）者居多，结肠（13．4％）者亦不少见。内镜及超声内镜检查53例（79．1％），其中行内镜引导下细针穿刺者1例；CT平扫及增强扫描14例（20．9％）。内镜下治疗45例（67．2％），外科手术治疗22例（32．8％），67例患者均治愈出院。结论随着双气囊小肠镜的开展及普及，小肠间质瘤诊断率明显提高。超声内镜辅助下行内镜下治疗，是诊治胃肠道间质瘤的有效手段之一。Objective To study the usage of endoscopy in diagnosis and treatment for gastroin- testinal stromal tumors （GIST）. Methods The clinical and pathological data, clinical manifestation, auxil- iary examination and treatment were retrospectively reviewed in 67 patients with GIST from Jan. 2004 to Jun. 2011 in our hospital. These patients were diagnosed by endoscopy examination（ including endoscopic uhrasonography） or iconography （plain CT scan or enhancement） and treated with endoscopy or surgery. Results There was no significant difference in GIST incidence rate between male and female,in the ma- jority with elderly people and 55 cases were above 45 years old （ 82.1% ）. The chief non-specific symp- toms included bloody stool （27 cases ,40.3% ）, abdominal pain（ 18 cases ,26.9% ） and abdominal dis- comfort （8eases, 11.9% ）. The region of GIST mainly located in stomach （38.8%）, small intestine （40.3 % ） and colon （ 13.4% ）. 53 patients （79.1% ）were diagnosed by endoscopy examination while 14 patients（ 20.9% ）were diagnosed by CT scan. 45 cases（67.2% ）were treated with endoscopy and 22 pa- tients（ 32.8% ）weretreated with surgery. All patients were cured and discharged after treatment. Conclu- sion With the development and popularity of double-balloon enteroscopy, the diagnostic accuracy of in- testinal stromal tumor is increased. Endoscopy assisted with endoscopic ultrasonography takes a significant position in diagnosis and treatment of gastrointestinal stromal tumor.

关 键 词：胃肠道 间质瘤 内镜 

分 类 号：R735[医药卫生—肿瘤]