介入性内镜超声学及发展前景

Prospect of Interventional Endoscopic Ultrasonography

随着电子线阵式超声内镜的发展,内镜超声引导下细针穿刺细胞学检查和内镜超声引导下细针注射技术已成为内镜医生诊治疾病的有力武器。实践证明,内镜超声引导下进行细针穿刺能准确地将针刺入病变中,而且通过内镜超声引导下进行引流已成为介入内镜的重要手段,对于胰腺囊肿,穿刺和引流同时具有诊断和治疗双重作用。内镜超声引导下胆管造影和引流有可能成为治疗胆道梗阻的一种替代方法,尤其是针对胃全切或毕Ⅱ氏胃大部切除术后的病人。内镜超声引导下注射是一种微创、安全的给药方式。通过内镜超声引导下细针注射进行腹腔神经丛阻滞可能效缓解胰腺癌的疼痛。通过内镜超声引导下注射给抗癌剂对局部进展期肿瘤提供了崭新的治疗方法。我们坚信,介入性内镜超声的应用前景必将是无限光明的。

With the advent of linear scanning color Doppler echoenodscopes. EUS guided punctures for fine-needle aspiration cytology and EUS guided fine needle injection （FNI） therapy have been added to the endoscopist＇s Experience with EUS-FNA of lesions has shown that it is possible to accurately place a needle into a small lesion with curcent curved linear array echoendoscopes. Moreover, EUS guided drainage have become an important field of interventional therapeutic endoscopy. EUS graded puncture and drainage may have a role in beth the evaluation and treatment of pancreatic cysts. EUS guided cholangiography and EUS-cholangio-drainage may be a potential altemative to percutaneous transhepatic biliary deainage and endoscopic retrograde cholangiography in the therapy of malignant pancreaticobiliary strictures, especially in patients who have andergone gastrectomy or partial gastrectomy with Billroth II reconstruction. EUS-guided FNI is an attractive delivery system because of its minimal invasiveness and low complication rate. This approach is effective delivery of antitumor agents in patients with locally advanced cancer. In the future, the application of interventional must be infinite.