探讨超声小探头对上消化道黏膜下肿瘤套扎治疗的指导性作用

Discussion on the guiding role of small ultrasonic probe in the treatment of submucosal tumors of upper digestive tract

目的探讨超声小探头对上消化道黏膜下肿瘤套扎治疗的指导性作用。方法68例上消化道黏膜下肿瘤患者,根据治疗前是否经超声小探头探查分为未经超声评估组(37例)与经超声评估组(31例)。所有患者均采用套扎器进行套扎治疗,严密观察有无出血、穿孔等并发症,术后定期门诊随访。观察内径检查结果并比较两组并发症发生情况。结果68例患者内镜检查结果:病灶大小为0.5~1.5 cm,位于食管39例,胃28例,十二指肠球部1例。未经超声评估组少量出血4例(10.8%),大出血2例(5.4%),穿孔5例(13.5%);经超声评估组少量出血3例(9.7%)。经超声评估组并发症发生率9.7%(3/31)低于未经超声评估组的29.7%(11/37),差异有统计学意义(P<0.05)。结论经超声小探头评估后对上消化道黏膜下肿瘤进行套扎治疗,方法简易、安全、有效,对其治疗有指导性作用。

Objective To discuss the guiding role of small ultrasonic probe in the treatment of submucosal tumors of upper digestive tract.Methods A total of 68 patients with submucosal tumors of upper digestive tract were divided into non-ultrasound evaluation group(37 cases)and ultrasound evaluation group(31 cases)according to whether they were probed by an ultrasound probe before treatment.All patients were treated with ligation device,closely observed for complications such as bleeding and perforation,and were followed up at regular outpatient clinics.The results of inner diameter examination were observed and the complications of the two groups were compared.Results Results of endoscopy in 68 patients:the lesion size was 0.5~1.5 cm,located in the esophagus in 39 cases,stomach in 28 cases,duodenal bulb in 1 case.There were 4 cases(10.8%)with minor hemorrhage,2 cases(5.4%)with massive hemorrhage and 5 cases(13.5%)with perforation in non-ultrasound evaluation group,and 3 cases(9.7%)with minor hemorrhage in ultrasound evaluation group.The incidence of complications 9.7%(3/31)of ultrasound evaluation group was lower than that of non-ultrasound evaluation group 29.7%(11/37),and the difference was statistically significant(P<0.05).Conclusion Ligation guided by small ultrasonic probe is a simple,safe and effective method for the treatment of submucosal tumors of upper digestive tract.