消化道炎性纤维性息肉的内镜诊疗情况及随访结果分析  

Analysis of endoscopic diagnosis and treatment of inflammatory fibrous polyps of digestive tract and follow-up results

作　　者：庞雨馨 何兴康 孙蕾民[1] PANG Yuxin;HE Xingkang;SUN Leimin(Department of Gastroenterology,Zhejiang University School of Medicine Sir Run Run Shaw Hospital,Hangzhou 310016,China)

机构地区：[1]浙江大学医学院附属邵逸夫医院消化内科,浙江杭州310016

出　　处：《健康研究》2023年第3期344-348,共5页Health Research

基　　金：国家自然科学基金青年项目(82203828)。

摘　　要：目的分析炎性纤维性息肉(inflammatory fibroid polyp,IFP)的内镜下特点,探讨不同内镜治疗方式治疗IFP的安全性和有效性,为IFP的临床诊治提供指导。方法回顾性分析93例经内镜诊治并经术后病理明确诊断的消化道IFP患者的临床资料。结果93例患者中,病灶位于食管1例(1.1%)、胃69例(74.2%)、小肠3例(3.2%)、大肠20例(21.5%),IFP最大径<3 cm者83例(89.2%),单发85例、多发8例,呈山田Ⅰ型的病灶51个、Ⅱ型29个、Ⅲ型10个、Ⅳ型11个。26个病灶行超声内镜检查,起源于黏膜层17个、黏膜下层9个,低回声13个、中等偏低回声7个、中等回声3个、高回声3个,全部被误诊。行直接切除42例,EMR 24例,ESD 27例,仅1例术中出血。中位随访时间为52个月,仅1例经直接切除的患者出现复发。结论IFP内镜下表现缺乏特异性,明确诊断主要依靠术后组织病理学结果,不同内镜下治疗方式均具有良好的安全性和有效性。Objective To analyze the endoscopic characteristics of inflammatory fibroid polyp(IFP),explore the safety and effectiveness of different endoscopic treatment methods for IFP,and provide guidance for clinical diagnosis and treatment of IFP.Methods The clinical data of 93 patients with gastrointestinal IFP diagnosed and treated by endoscopy was retrospectively analyzed.Results Among 93 patients,the lesions were located in the esophagus in 1 case(1.1%),stomach in 69 cases(74.2%),small intestine in 3 cases(3.2%),and large intestine in 20 cases(21.5%);83 cases(89.2%)with IFP maximum diameter<3 cm;85 had single lesion and 8 had multiple lesions;51 lesions were consistent with Yamada typeⅠ,29 for typeⅡ,10 for typeⅢ,and 11 for typeⅣ.26 lesions were examined by EUS,including 17 lesions originating from the mucosa and 9 lesions originating from the submucosa;13 low echoes,7 medium low echoes,3 medium echoes,and 3 high echoes;all were misdiagnosed.Direct resection was performed in 42 cases,EMR in 24 cases,and ESD in 27 cases;only one case had intraoperative bleeding.All patients were diagnosed by pathology.The median follow-up time was 52 months.Only one patient with direct resection of the lesion had recurrence.Conclusions The endoscopic manifestations of IFP are not specific.The definitive diagnosis depends mainly on the histopathological results after surgery.Different endoscopic treatments have good safety and effectiveness.

关 键 词：炎性纤维性息肉 临床特征 内镜表现 治疗方式 疗效 

分 类 号：R57[医药卫生—消化系统]