摘要
目的评价超声内镜对胃黏膜下肿瘤的诊断价值及在超声内镜辅助下行黏膜下肿瘤内镜治疗的意义。方法怀疑胃黏膜下肿瘤并行超声内镜检查诊断118例。根据黏膜下肿瘤的起源层次及性质决定治疗方案,内镜治疗包括高频电切术、内镜下黏膜切除术、黏膜剥离-肿瘤摘除术、黏膜剥离-肿瘤摘除术+钛夹封闭术。标本行病理学检查。结果16例良性间质瘤起源于黏膜肌层;脂肪瘤9例、异位胰腺17例、胃底静脉曲张5例、囊肿3例起源于黏膜下层;52例良性间质瘤及16例恶性间质瘤起源于固有肌层。14例源于黏膜肌层及3例源于固有肌层的良性间质瘤、8例脂肪瘤及8例异位胰腺经内镜切除,3例囊肿行内镜下穿刺治疗;18例源于固有肌层的良性间质瘤、14例恶性间质瘤、1例脂肪瘤及2例异位胰腺经手术切除。病理符合率为98.53%。结论超声内镜能够对胃黏膜下肿瘤进行起源和定性诊断,对黏膜下肿瘤治疗方案的选择具有重要的指导意义,内镜治疗是消化道黏膜下肿瘤治疗的安全、有效的手段,对拟诊黏膜下肿瘤者术前均应行超声内镜检查。
Objective To evaluate the diagnostic value of endoscopic uhrasonograpy （EUS） to submucosal tumors in stomach and the significance of EUS-assisted endoscopic therapy in the management of submucosal tumors of stomach. Methods From the patients who underwent endoscopy for dyspepsia at our unit 118 patients were found to have a presumed submucosal tumor （SMT） and all subjected to EUS. Endoscopic therapy including endoscopic mucosal resection （ EMR）, endoscopic mucosa strip removal-tumor extirpation, snare cauterization, sclerotherapy or surgical operation had been taken according to the different deriving layers of submucosal tumors. The ultimate diagnosis was confirmed by histology. Results Sixteen stromal tumors derived from mucosa; 9 lipomas, 17 ectopic pancreases in stomach, 5 varices, and 3 cysts in gastric fundus derived from submucosa; 52 benign stromal tumors and 16 malignant stromal tumors derived from muscularis. Fourteen benign stromal tumors derived from mucosa, 3 benign stromal tumors derived from muscularis, 8 lipomas, 8 ectopic pancreases, 3 cysts in stomach were rcsected via endoscope; 18 benign stromal tumors derived from muscularis, 14 malignant stromal tumors, 1 lipoma and 2 ectopic pancrease were operated. 98.53% submucosal tumors diagnosed by EUS were identified by pathology. Conclusion Different layers of stomach with submucosal tumors can be distinguished clearly by EUS, leading portant to select treating methods of submucosal tumors of stomach. Endoscopic therapy is an effective and safe method to submucosal tumor of stomach. EUS should routinely be performed on all presumptive submucosal tumors prior to attempts at removal.
出处
《第三军医大学学报》
CAS
CSCD
北大核心
2006年第3期260-262,共3页
Journal of Third Military Medical University
关键词
超声内镜
黏膜下肿瘤
内镜治疗
endoscopic ultrasonograpy
submucosal tumor
endoscopic therapy
