血管及血管瘤所致上消化道黏膜隆起的分布和内镜特点分析(含视频)  

Distribution and endoscopic characteristics of elevated lesions in the upper gastrointestinal tract caused by blood vessels and hemangiomas(with video)

作　　者：徐丽芬 胡端敏[1] 吴伟[1] 程桂莲[1] 徐丽明[1] 王卫军[2] 戴彦苗 张平[4] Xu Lifen;Hu Duanmin;Wu Wei;Cheng Guilian;Xu Liming;Wang Weijun;Dai Yanmiao;Zhang Ping(Department of Gastroenterology,The Second Affiliated Hospital of Soochow University,Suzhou 215004,China;Department of Gastroenterology,Changshu No.1 People's Hospital,Changshu 215500,China;Department of Gastroenterology,Kushan Hospital of Chinese Medicine,Kunshan 215300,China;Department of Gastroenterology,Traditional Chinese Medicine Hospital of Changshu,Changshu 215500,China)

机构地区：[1]苏州大学附属第二医院消化科,苏州215004 [2]常熟市第一人民医院消化科,常熟215500 [3]昆山市中医医院消化科,昆山215300 [4]常熟市中医院消化科,常熟215500

出　　处：《中华消化内镜杂志》2022年第3期238-241,共4页Chinese Journal of Digestive Endoscopy

基　　金：江苏省青年医学人才计划项目(QNRC2016864);苏州市医疗器械与新医药(临床试验)(SLT201927);姑苏卫生人才培养项目(GSWS2019012)。

摘　　要：本研究对2010年12月-2019年6月在苏州大学附属第二医院、常熟市第一人民医院、昆山市中医医院、常熟市中医院行内镜超声检查术(endoscopic ultrasonography,EUS)确诊为血管或血管瘤压迫的108个上消化道隆起病灶的内镜资料进行了回顾性总结,发现隆起主要分布于食管[50.9%(55/108)]和胃[47.2%(51/108)],各部又分别以食管中段[40.0%(22/55)]、上段[36.4%(20/55)]和胃体[66.7%(34/51)]、胃底[31.4%(16/51)]多见;多为脾动脉及动脉瘤压迫[29.6%(32/108)]、主动脉压迫[23.1%(25/108)]、孤立食管静脉瘤压迫[13.9%(15/108)]和胃黏膜下静脉及静脉瘤压迫[12.0%(13/108)],内镜下表现形态多样。以上结果提示,血管及血管瘤引起的上消化道隆起多由管腔外血管外压所致,但异位黏膜下动脉、孤立静脉瘤也不罕见,其分布广、胃镜下表现各异,EUS对明确诊断具有重要意义,必要时可联合彩色多普勒技术、CT平扫及血管重建以明确诊断。Endoscopic data of 108 upper gastrointestinal elevated lesions caused by vascular or hemangioma compression by endoscopic ultrasonography(EUS)at the Second Affiliated Hospital of Soochow University,Changshu No.1 People's Hospital,Kushan Hospital of Chinese Medicine and Traditional Chinese Medicine Hospital of Changshu from December 2010 to June 2019 were retrospectively summarized.The results showed that lesions were mainly located in the esophagus[50.9%(55/108)]and stomach[47.2%(51/108)],especially in the middle[40.0%(22/55)]and upper esophagus[36.4%(20/55)],body[66.7%(34/51)]and fundus of stomach[31.4%(16/51)],respectively.The major etiology included splenic artery and aneurysm compression[29.6%(32/108)],aortic compression[23.1%(25/108)],isolated esophageal venous aneurysm compression[13.9%(15/108)]and gastric submucosal vein and venous aneurysm compression[12.0%(13/108)],with diverse endoscopic presentation.The above results suggest that elevated lesions of upper gastrointestinal tract caused by blood vessels and hemangiomas are mostly due to external vascular pressure outside the lumen,but ectopic submucosal arteries and isolated phlebangioma are not uncommon.The lesions are widely distributed with different gastroscopic manifestations.EUS is important for definite diagnosis,and can be combined with color Doppler technique,CT plain scan and angiographic reconstruction if necessary.

关 键 词：内窥镜检查 胃肠道 血管瘤 上消化道黏膜下隆起 内镜超声检查术 

分 类 号：R732.2[医药卫生—肿瘤]