小探头内镜超声对消化道隆起性病变部位诊断及治疗方案的选择

Effect of miniprobe sonography on the diagnosis and the treatment options in the digestive tract protrude lesion

[目的]评价小探头内镜超声(miniprobe sonography,MPS)对消化道隆起性病变诊断及优化治疗方案选择的应用价值。[方法]采用MPS检查102例消化道隆起性病变患者,依据病灶状况决定治疗方案,内镜治疗包括内镜下高频电切术、黏膜切除术(EMR)、黏膜剥离术(ESD)、圈套切除术及内镜穿刺治疗。[结果]102例患者经MPS检查发现病灶位于大肠7例,胃57例,食管38例。依据病变类型分类:食管部位发现平滑肌瘤(15例)和息肉(9例),胃窦发现间质瘤(21例)和异位胰腺(12例),结肠发现脂肪瘤(4例)。69例行内镜治疗,33例行手术切除。7例异位胰腺、4例脂肪瘤及8例平滑肌瘤行ESD,4例异位胰腺、13例平滑肌瘤及2例间质瘤行EMR,3例脂肪瘤、4例息肉及1例囊肿行内镜高频电切术,9例息肉行内镜圈套切除术,2例食管外压及3例囊肿行内镜下穿刺治疗;神经内分泌肿瘤、胃淋巴瘤和各种癌症多行手术切除。MPS检测与病理诊断符合率为84.85%。[结论]MPS检查能有效诊断消化道隆起性病变情况,对患者治疗方案的制定具有指导价值。

[Objective]To evaluate the value of small probe endoscopic ultrasonography（MPS）in the di- agnosis and optimization of treatment options for digestive tract protrude lesion. [Methods]A total of 102 patients with the digestive tract protrude lesion were examined by miniprobe sonography. The significance of the treatment was determined according to the lesion. Endoscopic treatment includes endoscopic high fre- quency resection, endoscopic mucosal resection （EMR）, Endoscopic submueosal dissection （ESD）, excision and endoscopic treatment. [Results]In the 102 patients,7 cases the lesions were located in the colon,57 ca- ses the lesions were located in the stomach,38 cases the lesions were located in the esophagus. According to the classification of lesions, 15 cases were leiomyoma and 9 cases were polyps in esophageal,21 cases were stromal tumors and 12 cases were ectopic pancreas in stomach,and 4 cases were lipoma in the colon. 69 ca- ses accepted endoscopic treatment and 33 cases underwent surgical resection. Among them,7 cases of ectop- ic pancreas,4 cases of lipoma and 8 cases of leiomyoma underwent ESD. 4 cases of ectopic pancreas, 13 cases of leiomyoma and 2 cases of stromal tumor underwent EMR. 3 cases of lipoma,4 cases of polyps and 1 case of cyst were treated with endoscopic high-frequency excision. Nine cases of polyps accepted endoscopic re- section,2 cases of esophageal protrude lesion were derived from foreign body and 3 cases accepted endo- scopic cyst puncture. Neuroendocrine tumors, gastric lymphoma and various types of cancer accepted sur- gery resection. The coincidence rate of MPS detection and pathologic diagnosis was 84.85 %. [Conclusion]MPS can effectively diagnose the digestive tract protrude lesion and provide a guiding value for the treat ment option.