黑斑胃肠道息肉综合征的综合治疗

Comprehensive treatment of Peutz-Jeghers syndrome

目的 探讨黑斑胃肠道息肉综合征 (PJS)黏膜黑斑及消化道息肉的治疗方法及预防息肉癌变措施。方法 ①对黏膜黑斑采用CO2 激光治疗 ,治疗输出功率 15～ 2 0W ,分 3～ 4次治疗完毕 ;②胃、十二指肠和结肠息肉用内镜分次进行激光治疗 ;③对小肠息肉患者预防肠梗阻的治疗 ,应先做气钡双重造影X线检查 ,对直径 >2cm并有多枚息肉时应手术治疗 ,摘除息肉采用肠管小切口多点位方法 ;④结肠息肉多而体积大者应做全结肠切除术。结果 ①黏膜黑斑经激光治疗 95 %黑斑可以清除 ;②采用肠管小切口多点位摘除息肉一般不发生肠管狭窄并可避免短肠综合征发生 ;③结肠息肉需彻底治疗并每年复查治疗 1次。结论 清除黏膜黑斑可以解除患者沉重心理负担 ;肠管小切口多点位摘除术可以避免肠管切除过多发现短肠综合征而引起的消化及吸收不良 ;积极彻底治疗结肠息肉并每年复查治疗

Objective Researching the methods of treating Peutz-Jeghers syndrome and preventing its cancerization.Methods ① Using the laser of CO 2 to treat the black spots of mucosa for 3～4 times.The power of laser is between 15～20 W.② By endoscopy,using laser to treat the polyps of ventriculus,duodenum and colon for several times.③ For polyps of small intestine the occurrence of obstruction must be prevented:after pneumobarium double contrast examination,those polyps with a diameter over 2 cm should be operated on using a-small-axillary-incision and multi-point operation.④ More and big colon polyps should be operated on by total excision.Results ① After the laser treatment 95 percent of black spots of mucosa can be eliminated;② Using small-axillary-incision and multi-point operation,stenosis of small intestine and short bowel syndrome can be avoided;③Colon polyps should be comprehensively treated and checked per year.Conclusion Eliminating the black spots of mucosa can relieve the patients from heavy psychological burden.The small-axillary-incision and multi-point operation can avoid indigestion in case of short bowel syndrome.Actively thorough cleaning the colon polyps and follow-up examination annually is the main measure taken to prevent the polyps from cancerization.