上消化道病变超声内镜检查67例分析

Clinical Analysis of 67 Cases of Endoscopic Ultrasonography with the Lesions in Upper Gastrointestinal Tract

目的 报告和评价超声内镜 (EU S)对上消化道病变的诊断价值。方法 应用 EUS检查上消化道病灶 6 7例 ,在EUS检查前均经胃镜检查并发现食管、胃内或十二指肠内有隆起性病灶或其他病灶 ,部分患者并进行了 X线钡剂检查 ,但诊断未能确定。结果 EU S检查的 6 7例患者中发现食管平滑肌瘤 5例 ,食管静脉瘤 1例 ,胃平滑肌瘤 6例 ,胃平滑肌肉瘤 2例 ,胃脂肪瘤 2例 ,胃淋巴瘤 1例 ,胃息肉 3例 ,胃溃疡 1例 ,胃癌 1例 ,胃外压迫 1 8例 ,胰尾占位 1例 ,慢性胰腺炎 2例 ,未见明显异常者 2 4例。部分病例经剖腹探查或内镜病理检查等证实。经 EUS检查明确诊断的为 6 4例 (95 .1 % ) ,而经内镜检查明确诊断的为 37例 (5 5 .0 % ) ,证明 EU S对上消化道隆起性病变的诊断优于内镜。结论 EU S对上消化道病变的诊断与鉴别诊断具有一定的价值 ,在有条件的医院可以利用此项技术诊断部分有疑问的上消化道病变。

Objective To report and evaluate the diagnostic value of endoscopic ultrasonography (EUS) in the lesions of upper gastrointestinal tract. Methods 67 patients with upper gastrointestinal lesions were examined by endoscopic ultrasonography and they all had bulge or other focus in esophagus, stomach and duodenum by gastroscopy. Some of the patients also received X ray barium meal examination, but had no definite diagnosis. Results The diseases of 67 patients distributed as follows: 5 esophageal leiomyoma; 1 esophageal venous aneurysm; 6 gastric leiomyoma; 2 gastric leiomyosarcoma; 2 gastric lipoma; 1 gastric lymphoma; 3 gastricpolyp; 1 gastric ulcer; 1 gastric cancer; 1 mass in tail of pancreas; 18 oppression from outside of stomach; 24 patients with no obvious abnormality. Some diseases were verified by surgical operations and pathological examinations. 64 cases were definitely diagnosed by EUS with a rate of 95.1%. In contrast only 37(55.2%) of them were diagnosed by simple endoscopy. It confirms that EUS is superior to endoscopy in locating the lesions in upper gastrointestinal tract. Conclusion EUS has certain value in the diagnosis and differential diagnosis of the lesions in upper gastrointestinal tract. It can be used in indefinite diagnosis of patients in clinical work.