上消化道平滑肌瘤的内镜超声检查随访观察

Follow-up study on upper gastrointestinal tract leiomyoma by endoscopic ultrasonography

目的探讨上消化道平滑肌瘤的生长速度。方法采用内镜超声检查对18例上消化道平滑肌瘤患者每6个月进行跟踪检查一次,测定平滑肌瘤的最长径(A,mm);并计算出每月的生长速度。结果以最大径为10～20mm平滑肌瘤为最多见。肿瘤最大径A≤10mm者生长速度为(0.052±0.034)mm/月,10mm<A≤20mm者为(0.115±0.083)mm/月,20mm<A≤30mm者为(0.247±0.106)mm/月,30mm<A≤40mm者为(0.386±0.135)mm/月。肿瘤最大径于30至40mm之间的生长速度较肿瘤小于10mm者明显加快(P<0.05)。结论上消化道平滑肌瘤以最大径10～20mm者多见,肿瘤最大径大于30mm者生长速度较快,须密切随访;肿瘤最大径较小(小于10mm)时可延长患者内镜超声检查的复查时间。

Objective To observe the growth characters of upper gastrointectinal tract leiomyoma. Methods Using endoscopic ultrasonography to detect leiomyoma of upper gastrointestinal tract leiomyoma in 18 cases once every 6 months on follow-up , and to measure the longest diameter ( A mm) and calculate its growth rate per month. Results In this series,the majority of cases have the leiomyoma of longest diameter(A) 10～20mm. Their growth rates in A≤10mm, 10mm<A≤20mm, 20mm<A≤30mm and 30mm<A≤40mm were 0.052±0.034mm/month, 0.115±0.083mm/month, 0.247±0.106mm /month and 0.386±0.135mm/month respectively. The growth rate in leiomyoma of 30mm<A≤40mm is significantly different from that of A≤10mm (P< 0.05). Conclusion The highest growth rate was found in those leiomyoma with longest diameter more than 30mm.It is suggested to observe the larger leiomyoma periodically at shorter interval,while for those with A≤10mm the interval between endoscopies may be reasonably prolonged.