胃肠道炎性纤维性息肉的内镜诊断与治疗  

Endoscopic diagnosis and treatment of inflammatory fibroid polyps

作　　者：许良璧[1] 项一宁[2] 

机构地区：[1]贵阳医学院附属医院消化内镜中心,贵州省贵阳市550001 [2]贵阳医学院附属医院病理科,贵州省贵阳市550001

出　　处：《世界华人消化杂志》2014年第35期5550-5555,共6页World Chinese Journal of Digestology

摘　　要：目的:探讨消化系炎性纤维性息肉(inflammatory fibroid polyp,IFP)的临床表现、内镜特征、内镜下的鉴别诊断以及内镜下治疗方法.方法:收集13例消化系炎性纤维性息肉,进行临床、内镜、超声内镜观察及内镜下治疗方法的探索.结果:消化系的炎性纤维性息肉主要发生在50岁以上人群(85%),女性略占优势.发生的部位依次为胃窦(10例)、回肠(2例)和结肠(1例).内镜下主要表现为黏膜下隆起、息肉及新生物样隆起.超声内镜下表现为第3层(3例)或第2层(2例)的低回声,内部回声均匀,与周围组织界限欠清.内镜下4例行内镜下黏膜切除术(endoscopic mucosal resection,EMR),6例行内镜黏膜下剥离术(endoscopic submucosal dissection,ESD)治疗,2例胃和1例小肠呈新生物隆起的进行局部切除术.结论:胃窦是炎性纤维性息肉最常见的发病部位.超声内镜和内镜下的表现对诊断有一定帮助.绝大多数IFP在内镜下呈黏膜下隆起及息肉的外观.内镜下进行ESD或EMR手术是安全、有效的.有限的随访资料证明内镜治疗IFP后无复发.AIM： To investigate the clinical manifestations, endoscopic and ultrasonographic features, and endoscopic therapy of gastric inflammatory fibroid polyps （IFPs）. METHODS： A total of 13 patients with IFPs treated at our center were collected between January 2007 January and April 2014. The clinical data for these patients were reviewed. All patients underwent digestive endoscopy, and 5 patients whose lesions were located at the antrum underwent endoscopic ultrasonography before therapy. Therapeutic methods were selected based on endoscopic morphology of the lesion. RESULTS： IFPs had a modest female predominance （8 women and 5 men）, with the majority of patients （11） being more than 50 years. Involved sites included the stomach （10）, ileum （2）, and colon （1）. The tumors ranged in size from 6-60 mm （mean, 21.62 mm）. Endoscopic features of the 13 lesions were submucosal tumors （7）, polyps （3） and neoplasms （3）. All lesions were located in the second （2） or third （3） sonographic layer of the antrum without involvement of the fourth layer. Endoscopic ultrasonographic features were hypoechoic/homogeneous echo pattern and unclear boundary. Four patients underwent endoscopic mucosal resection （EMR）, 6 underwent endoscopic submucosal dissection （ESD） and 3 partial gastrointestinalresection. All were confirmed histologically as IFPs. CONCLUSION： IFPs can occur throughout the gastrointestinal tract, commonly in the antrum. Understanding the characteristic digestive endoscopy and EUS features of IFP scan be helpful to IFP diagnosis. Treatmentby EMR or ESD iseffective and safe.

关 键 词：炎性纤维性息肉 胃镜 肠镜 超声内镜 内镜下黏膜切除术 内镜黏膜下剥离术 

分 类 号：R57[医药卫生—消化系统]