超声内镜辅助下上消化道粘膜下肿瘤切除术的护理配合  

Value of nursing cooperation in endoscopic resection of upper gastrointestinal submucosal tumor

作　　者：叶婉华[1] 欧燕妮[1] 谢路萍[1] 纪海玲[1] 林世永[1] 李练[1] 钟碧绿[1] 高宗娥[1] 

机构地区：[1]华南肿瘤学国家重点实验室中山大学肿瘤防治中心内镜激光科,广东广州510060

出　　处：《齐齐哈尔医学院学报》2012年第23期3292-3294,共3页Journal of Qiqihar Medical University

摘　　要：目的探讨内镜下上消化道粘膜下肿瘤切除术的护理配合,提高手术的成功率,减少术中、术后的并发症,减轻患者的痛苦及术前进行超声内镜检查的意义。方法对普通内镜检查发现的135例上消化道粘膜下肿瘤的患者(食管68例,胃55例,十二指肠12例)进行超声内镜检查,以评估其内镜下治疗的可行性,然后根据实际情况确定具体的内镜治疗方案再择期行内镜下治疗。现对内镜下肿瘤切除术护理配合的方法进行总结。结果经超声内镜检查后认为可行内镜下治疗的97例病变经病理检查均获得完整切除,其中食管平滑肌瘤48例,食管脂肪瘤2例,胃平滑肌瘤21例,胃间质瘤9例,胃类癌2例,胃异位胰腺10例,十二指肠平滑肌瘤1例,十二指肠异位胰腺3例,十二指肠脂肪瘤1例。超声内镜与病理诊断符合率为95.5%。切除病变最大直径3.5cm(平均1.3cm)。6例病变术中出血较多,予内镜下处理后均成功止血;术中、术后未见穿孔发生。所有切除病变基底和切缘未见肿物残留。病例随访6～24月(平均12月)未见肿瘤复发。结论内镜下治疗上消化道粘膜下肿瘤是安全而有效的,且术中熟练、灵敏的护理配合是提高手术的成功率,减少术中、术后的并发症,减轻患者痛苦的关键,且术前超声内镜检查对于内镜治疗有重要的指导意义。Objective To investigate the value of nursing cooperation in endoscopic resection of upper gastrointestinal submucosal tumor for elevating success rate of operation,diminishing complications during and after resection and relieving discomfort of patients. Methods 135 cases of upper gastrointestinal submucosal tumor found by conventional endoscopy received endoscopic ultrasonography and the resectability was evaluated.All the 135 lesions included 68 cases of esophagus,55 cases of stomach and 12 cases of duodenum,which were treated properly according to the results of the endoscopic ultrasonography.The experience of nursing cooperation in endoscopic resection was concluded. Results 97 lesions received complete endoscopic resection which were confirmed by endoscopic ultrasonography,including 48 cases of esophageal leiomyoma,2 cases of esophageal lipoma,21 cases of gastric leiomyoma,9 cases of gastric interstitialoma,2 cases of gastric carcinoid,10 cases of gastric heterotopic pancreas,1 case of duodenal leiomyoma,3 cases of duodenal heterotopic pancreas and 1 case of duodenal lipoma.The concordance rate between endoscopic ultrasonography and pathological diagnosis was 95.5%.The maximal diameter of resected specimens was 3.5 cm,1.3 cm on average.Obvious intraoperative bleeding occurred in 6 cases,which were successfully treated under endoscope.There were no case of perforation.No tumor cell was found in the base or edge of the resected specimens.No recurrence existed during the follow up of 6 to 24 months,12 months on average. Conclusions Endoscopic resection of upper gastrointestinal submucosal tumor is safe and effective.Proficient and smart nursing cooperation is useful for elevating success rate of operation,diminishing complications during and after resection and relieving discomfort of patients.Preoperative endoscopic ultrasonography is helpful for the choice of proper treatment.

关 键 词：超声内镜 肿瘤 

分 类 号：R735[医药卫生—肿瘤]