EUS引导下介入治疗现状  

Progress in research of endoscopic ultrasound-guided interventional therapy

作　　者：王金林 陈倩[1] 王云[1] 侯伟 郭巧珍 程斌 

机构地区：[1]华中科技大学同济医学院附属同济医院消化内科,湖北省武汉市430030

出　　处：《世界华人消化杂志》2017年第26期2353-2359,共7页World Chinese Journal of Digestology

摘　　要：内镜超声检查术(endoscopic ultrasonography,EUS)引导下介入治疗是目前EUS发展的重要方向,主要包括EUS引导下腹腔神经丛阻滞术(EUS-guided celiac plexus neurolysis,EUS-CPN)、EUS引导下胰腺假性囊肿引流、EUS引导下胆管引流(EUS guided biliary drainage,EUS-BD)、超声内镜引导下肿瘤注射治疗等.EUS-CPN效果优于传统镇痛治疗;无论是首次CPN治疗是否有效,再次进行CPN治疗价值有限;选择单侧注射还是双侧注射与操作者习惯及熟练程度有关,在治疗效果上目前没有明显差异.EUS引导下假性囊肿引流为符合引流条件的患者首选方法.EUS-BD的有效性和安全性基本已经得到了认可.EUS引导下酒精注射治疗目前是不适合手术或不愿意接受手术的胰腺神经内分泌肿瘤患者最佳的选择;内镜超声引导下射频消融与EUS引导下胰腺癌注射治疗价值有待进一步证实.Endoscopic ultrasound （EUS）-guided interventional therapy is an important research direction of EUS, and it mainly includes EUS-guided celiac plexus neurolysis （EUS-CPN）, EUS-guided pseudocyst drainage, EUS-guided biliary drainage （EUS- BD）, and EUS-guided fine needle injection （EUS-FNI）. The therapeutic effect of EUS- CPN was superior to that of traditional analgesic therapy. No matter whether the first CPN therapy is effective, the effect of a second CPN is limited. Choosing unilateral or bilateral injection is related to operators＇ habits and proficiency, and there is no obvious difference in therapeutic effect. EUS-guided pseudocyst drainage is the best choice for patients who have the indications for drainage. The efficacy and safety of EUS-BD have been confirmed. EUS- guided ethanol injection is currently the best therapeutic method for patients with pancreatic neuroendocrine tumors who are not suitable for or unwilling to undergo surgery. The therapeutic value of EUS-RFA and EUS-FNI for pancreatic cancer remains to be further confirmed.

关 键 词：超声内镜引导下介入治疗 EUS引导下腹腔神经丛阻滞术 EUS引导下胰腺假性囊肿引流 EUS引导下胆管引流 EUS引导下肿瘤注射治疗 

分 类 号：R735.9[医药卫生—肿瘤]