CAJ | 학술논문

目的评价超声内镜检查对上消化道黏膜下肿瘤的诊断价值及指导内镜下微创治疗黏膜下肿瘤的疗效及安全性.方法经超声内镜诊断上消化道黏膜下肿瘤82例,根据黏膜下肿瘤的起源层次、大小及性质分别选择不同的内镜治疗方案,内镜治疗包括高频电凝电切术、内镜下黏膜切除术、皮圈套扎术等.标本行常规病理学及免疫组化检查.术后定期内镜随访.结果 26例超声判断起源于黏膜肌层的上消化道黏膜下肿瘤行高频电凝电切术;17例起源于黏膜肌层的平坦型上消化道黏膜下肿瘤行内镜下黏膜切除术;38例起源于固有肌层和1例起源于黏膜肌层的上消化道黏膜下肿瘤行皮圈套扎术.内镜超声诊断与术后病理符合率为91.4%.术后1例出血,其余无严重并发症发生.79例术后随访3～24个月无复发.结论超声内镜能够对消化道黏膜下肿瘤进行起源和定性诊断,超声内镜为内镜微创治疗选择消化道黏膜下肿瘤适应证具有良好的指导作用,内镜治疗是消化道黏膜下肿瘤治疗的安全、有效的手段.
목적 평개초성내경검사대상소화도점막하종류적진단개치급지도내경하미창치료점막하종류적료효급안전성.방법 경초성내경진단상소화도점막하종류82례,근거점막하종류적기원층차、대소급성질분별선택불동적내경치료방안,내경치료포괄고빈전응전절술、내경하점막절제술、피권투찰술등.표본행상규병이학급면역조화검사.술후정기내경수방.결과 26례초성판단기원우점막기층적상소화도점막하종류행고빈전응전절술;17례기원우점막기층적평탄형상소화도점막하종류행내경하점막절제술;38례기원우고유기층화1례기원우점막기층적상소화도점막하종류행피권투찰술.내경초성진단여술후병리부합솔위91.4%.술후1례출혈,기여무엄중병발증발생.79례술후수방3～24개월무복발.결론 초성내경능구대소화도점막하종류진행기원화정성진단,초성내경위내경미창치료선택소화도점막하종류괄응증구유량호적지도작용,내경치료시소화도점막하종류치료적안전、유효적수단.
Objective To evaluate the diagnostic value of endoscopic ultrasonography (EUS) for submucosal tumors in upper gastrointestinal tract, and its influence on choice of endoscopic therapies. Methods A total of 82 submucosal tumors from upper gastrointestinal tract were examined by EUS, and treated by various endoscopic therapeutic techniques including fulguration with high frequency current ( FHFC), endoscopic mucosal resection (EMR) and endoscopic band ligation according to orion, size and property of the lesion. The diagnoses of 58 reseeted samples were determined by routine pathological examination and immunohistochemistry. All patients were followed up with routine endoscopy and EUS. Results FHFC was applied in 26 lesions originated from muscularis mucosa, EMR was used in 17 flat lesions originated from muscularis mucosa, and endoscopic band ligation in 38 lesions from muscularis propria and 1 tumor from muscularis mucosa. The diagnostic accuracy of EUS was 91.4% (53/58). Except for post-operative bleeding in 1 patient, no other complications were observed. A total of 79 cases were followed up for 3-24 months, and no recurrence was found. Conclusion EUS can display the origin and property of submucosal tumors in upper gastrointestinal tract and guide the selection of endoscopic therapy, which is effective and safe in treatment of submucosal tumor in upper gastrointestinal tract.