内窥镜超声对上消化道黏膜下隆起病变的诊断价值分析

Diagnostic Value of Endoscopic Ultrasonography for Submucosal Lesions of Upper Digestive Tract

目的探讨内窥镜超声在上消化道黏膜下隆起病变治疗前进行检查评估,对于病变诊断和治疗的指导意义。方法于2018年1月—2019年5月期间,方便选择50例上消化道黏膜下隆起病例,使用小探头超声或者超声胃镜进行评估,判断肿物起源于上消化道壁的层次、大小以及性质,并充分注意是否为血管或腔外压迫,来指导治疗方法的选择。结果超声内镜诊断上消化道黏膜下隆起病变的符合率与手术结果相比,其符合率,差异无统计学意义(χ^2=1.43,P>0.05)。50例手术治疗的上消化道黏膜下隆起病例,超声内镜诊断与病理符合的患者例数48例,比率96.00%;超声内镜诊断脂肪瘤的准确度较高,但是,在中低回声病变中的诊断效果并不是十分理想。结论内镜超声对于上消化道黏膜下隆起的诊治具有重要的指导价值。通过内镜超声的评估,可指导治疗方式的选择:胃镜下手术治疗,外科手术治疗或者无需治疗。建议对于上消化道黏膜下隆起在治疗前均使用内镜超声检查,从而选择合适的治疗方式。

Objective To investigate the role of endoscopic ultrasonography in the evaluation of upper gastrointestinal submucosal bulging lesions before treatment,and to guide the diagnosis and treatment of lesions.Methods From January 2018 to May 2019,convenient selected 50 cases of upper gastrointestinal submucosal bulge were selected and evaluated by small probe ultrasound or ultrasound gastroscope to determine the level and size of the mass originating from the upper digestive tract wall nature,and pay full attention to whether the blood vessels or extraluminal compressions,to guide the choice of treatment.Results Compared with the surgical results,the coincidence rate of endoscopic diagnosis of upper gastrointestinal submucosal lesions was not statistically significant,the difference was notstatistically significant(χ^2=1.43,P>0.05)50 cases of upper gastrointestinal mucosa treated with surgery In the case of bulging,the number of patients with ultrasound endoscopic diagnosis and pathology was 48 cases,the ratio was 96.00%;the accuracy of endoscopic diagnosis of lipoma was higher,but the diagnostic effect in low and medium echo lesions was not very satisfactory.Conclusion Endoscopic ultrasonography has important guiding value for the diagnosis and treatment of submucosal bulge in the upper digestive tract.Endoscopic ultrasound assessment can guide the choice of treatment:endoscopic surgery,surgical treatment,or no treatment.It is recommended to use endoscopic ultrasonography for the upper gastrointestinal submucosal bulge before treatment to select the appropriate treatment.