内镜黏膜下挖除术治疗胃血管球瘤1例  

Endoscopic submucosal dissection for the treatment of gastric glomerulus tumor:a case report

作　　者：揭敏 Jie Min(Hunan Aerospace Hospital,Changsha,Hunan 410000,China)

机构地区：[1]湖南航天医院,湖南长沙410000

出　　处：《首都食品与医药》2024年第24期30-33,共4页Capital Food Medicine

摘　　要：总结1例胃血管球瘤患者的治疗措施,分析内镜黏膜下挖除术治疗胃血管球瘤的价值。患者内镜下可见胃窦后壁有一椭圆形隆起,长径约2.5cm,质地软,活动度可,表面黏膜光滑,与周围黏膜一致。免疫组化:Calponin(+),Caldesmon(+),SMA(+),NSE(灶+),Syn(灶+),Ki-67(<5%+)。治疗要点:选择内镜黏膜下挖除术(endoscopic submucosal excavation,ESE)+荷包缝合术,以甘油果糖+靛胭紫+肾上腺素多点注射边缘行黏膜下抬举,抬举征(-),Dualknife切开黏膜层暴露黏膜下肿物,肿物位于固有肌层,沿肿物边缘逐层分离至浆膜层,可见小部分肿物突出于胃壁外,切开部分胃壁后以50W的电圈套器套住肿物底部,分两次完整切除。患者术后无明显腹痛,无呕血、便血,无发热等不适,予以出院。To summarize the treatment measures of a patient with gastric glomus tumor and analyze the value of endoscopic submucosal excavation in the treatment of gastric glomus tumor.Under endoscopy,an oval-shaped bulge was visible in the posterior wall of the gastric antrum of the patient,with a long diameter of approximately 2.5cm.The texture was soft,the mobility was acceptable,and the surface mucosa was smooth,consistent with the surrounding mucosa.Immunohistochemistry:Calponin(+),Caldesmon(+),SMA(+),NSE(focal+),Syn(focal+),Ki-67(<5%+).Key points of treatment:Endoscopic submucosal excavation(ESE)+purse-string suture was selected.Glycerin fructose+indigo carmine+epinephrine was injected at multiple points at the edge for submucosal lifting.The lifting sign was negative.The mucosal layer was incised with Dualknife to expose the submucosal tumor.The tumor was located in the proper muscle layer.It was separated layer by layer along the edge of the tumor to the serosal layer.A small part of the tumor was observed to protrude outside the gastric wall.After incising part of the gastric wall,the bottom of the tumor was trapped with a 50W electric snare and completely resected twice.The patient had no obvious abdominal pain,no hematemesis,no hematochezia,no fever or other discomfort after the operation and was discharged.

关 键 词：胃血管球瘤 内镜黏膜下挖除术 治疗 病理特征 

分 类 号：R735.2[医药卫生—肿瘤]