内镜下套扎术治疗胃固有肌层间质瘤的研究

Research for the treatment of gastric stromal tumor by endoscopic TaoZha technique

目的：研究内镜下套扎起源于固有肌层胃间质瘤的优越性、安全性和有效性。方法选取烟台毓璜顶医院2012年1月至2013年l 月，经内镜和超声内镜检查，证实为起源于固有肌层的胃间质瘤，内镜下目测大小≤1.2 cm，同意接受内镜下套扎治疗的患者38例，采用橡皮圈单环套扎治疗。术后l～2周复查胃镜，对尚未完全坏死脱落的病变再次勒扎，至残留病变呈紫红色。结果经内镜和超声内镜复查，治疗l～2周后病变均坏死脱落，局部溃疡形成，继续抑制胃酸治疗3～6个月后，复查内镜和超声内镜，上述溃疡愈合，局部疤痕形成，胃壁结构基本恢复正常。随访持续1～24个月，1例出现黑便，1例出现轻微气腹及局限性腹膜炎，经治疗后均恢复正常，38例患者无一例复发。而且相对于外科手术，该方法更为经济。结论对于大小≤1.2 cm，起源于固有肌层的胃间质瘤，可采用内镜下套扎治疗，且可能为一种安全、有效、经济的微创治疗手段。

ObjectiveThe study about the muscularis propria, safety and efficacy of using the rubber band ligation to treat gastric stromal tumor which originated from the muscularis propria.Methods Select our hospital between January 2012 and 2013 months, l by endoscope and endoscopic ultrasonography examination, proved to have originated in gastric stromal tumor to the muscularis propria, endoscopic visual size no more than 1.2 cm, and sign the informed consent, agree to accept Endoscopic Variceal Ligation treatment of 38 patients, using rubber band monocyclic treatment.That is, Using plastic le device,to the base of the lesion, gradually tightening RPH tied to local mucosal lesion is purple, l review gastroscope, a week or two after le again for not fully necrosis falls off lesions, and residual lesions in purple.ResultsChecked bying the endoscope and endoscopic ultrasonography,38 cases of lesions, Treat l fall off after a week or 2 lesions were necrosis, local ulceration, continue to inhibit gastric acid treatment 3-6 months after a review of the endoscope and endoscopic ultrasonography, the ulcer healing, local scar formation, the stomach after endoscopic treatment often effective structure, 38 patients were followed up for 1 a 24 months, One appeared in black,one appeared mild pneumoperitoneum limitations and peritonitis, they were all back to normal after treatment, 38 patients with no recurrence.And that Relative to surgery ,It has more economic benefits. ConclusionFor no more than 1.2 cm size, originated in the gastric stromal tumor to the muscularis propria, using endoscopic therapy may be a safe 、effective、economic、minimally invasive treatment.