小探头超声内镜对十二指肠降部隆起性病变的诊治价值

Value of miniprobe endoscopic ultrasonography in the diagnosis and treatment of submucosal lesions at duodenal descending part

目的研究小探头内镜超声检查(mEUS)对十二指肠降部隆起性病变的诊断价值,并行内镜下结扎或电切除治疗,探索十二指肠降部隆起性病变的诊治方法。方法对60例患者的72个十二指肠降部黏膜下隆起病变行超声内镜检查,判断其起源,确立内镜诊断。根据不同病变选择内镜下结扎治疗或电切除术,部分病例经手术或病理证实。结果 72个十二指肠降部黏膜下病变中,间质瘤33个,囊肿27个,脂肪瘤9个,血管瘤3个,根据不同的病变选择结扎治疗或内镜下电切除术,未发生内镜治疗相关的并发症,3个月后复查见原病变处已形成瘢痕。结论小探头内镜超声检查对十二指肠降部黏膜下病变有重要的诊断价值,在其指导下的结扎或电切除术对十二指肠降部隆起病变有良好的治疗作用。

【Objective】To evaluate the usefulness of miniprobe endoscopic ultrasonography （mEUS） in the diagnosis of submucosal lesions at duodenal descending part. The lesions were treated with endoscopic ligation or resection method, to explore a method for the diagnosis and treatment for submucosal lesions at duodenal descending part. 【Methods】72 lesions of 60 patients were examined with mEUS, endoscopic diagnosis was confirmed, according to the origin of the lesion, endoscopic ligation or resestion was used. Some lesions were confirmed with pathologic diagnosis. 【Results】Among the 72 lesions, 33 were diagnosed ultrasonographally as gastrointestinal stromal tumor （GIST）, 27 cyst, 9 adipoma, 3 angioma. They were treated with endoscopic ligation or resection, no complication occurred. Endoscopic examination was taken for the patients underwent endoscopic therapy, the lesion disappeared and scar could be observed three months later.【Conclusions】mEUS has great value in the diagnosis of submucosal lesions at duodenal descending part. With the guidance of mEUS, endoscopic ligation or resection was an effective measure for the treatment of submucosal lesions at duodenal descending part.