| 吴锋 王婷婷 刘宇新 刘鸿儒 杨幼林△.常见消化道黏膜下肿物的临床特点及治疗方法[J].,2016,16(27):5276-5279 |
| 常见消化道黏膜下肿物的临床特点及治疗方法 |
| Clinical Characteristics and Treatment Methods for Common GastrointestinalSubmucosal Tumors |
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| DOI： |
| 中文关键词: 消化道黏膜下肿物 内镜下治疗 特征 安全性 |
| 英文关键词: Gastrointestinal submucosal tumors Endoscopic treatment Characteristic Security |
| 基金项目:黑龙江省中医药科研项目（ZHY12-Z139） |
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| 中文摘要: |
| 目的：探讨常见消化道黏膜下肿物( submucosal tumors, SMTs)的临床特点、治疗方式及安全性。方法：选择2014 年5 月至
2016年3 月在哈医大一院经内镜切除的并经病理及免疫组化明确诊断的消化道粘膜下肿物的患者共49 例。所有患者术后3 个
月、6个月及12个月后随诊复查胃镜。统计每种肿物的患者临床症状，各种黏膜下肿物的性别分布、大小，及在消化道的分布。计
算超声内镜的诊断率，总结病理结果。结果：49 例患者中，间质瘤25 例，类癌9 例，平滑肌瘤8 例，异位胰腺4 例，脂肪瘤2例，颗
粒细胞瘤1 例。间质瘤分布以胃底、胃体多见。类癌以直肠最多见，胃内也可见。平滑肌瘤多分布于食管，也可见于胃。异位胰腺
多分布于胃窦。通过内镜黏膜下挖除术(Endoscopic submucosal excavation, ESE) 切除42 例，粘膜下隧道切除术(Submucosal tunneling
endoscopic resection, STER)切除4 例，还有3 例行内镜下黏膜切除（Endoscopic Mucosal Resection, EMR）。所有患者术后均
无迟发性出血、严重感染及死亡病例发生。随访3-22 个月，所有患者均无复发。结论：黏膜下肿物在内镜及超声内镜各有特点。超
声内镜对黏膜下肿物的诊断与治疗具有重要的指导意义。双镜联合使SMTs 的内镜下各种治疗方式（EMR、ESE、STER）更有安全
保障，使患者受益最大。 |
| 英文摘要: |
| Objective:This study is to explore the clinical features of common gastrointestinal submucosal lesions, treatments and
its safety.Methods:49 patients with submucosal tumors approved by endoscopic resection from May 2014 to January 2016 at the First
Clinical Hospital affiliated to Harbin Medical University were pathologically diagnosed and enrolled. All patients underwent endoscopy
during follow-up period of three, six and twelve months after operation. Clinical symptoms of each patient, gender distribution, size and
distribution of various kinds of submucosal lesions in the digestive tract were counted. Diagnostic rate of EUS and immunohistochemical
results were also summarized.Results:The diagnosis of 49 cases of gastrointestinal submucosal tumor was 25 cases of gastrointestinal
stromal tumor, 9 cases of carcinoid, 8 cases of gastrointestinal leiomyoma, 4 cases of heterotopic pancreas, 2 cases of lipoma and 1 case
of granular cell tumor. GIST was mainly distributed in the bottom and body of the stomach. Carcinoid was seen most frequently in rectum,
and also visible in the stomach. Leiomyoma was more common in the esophagus, also seen in the stomach. Heterotopic pancreas appears
mostly in gastric antrum. 42 cases of submucosal tumor were resected by ESE, 4 cases by STER and 3 cases by EMR. There were
no delayed bleeding, severe infection and death occurred in these cases. During the postoperative follow-up period of 3 to 22 months, all
patients had no recurrence.Conclusion:Submucosal lesions have their own characteristics under endoscope and endoscopic ultrasonography.
EUS has an important guiding role on the diagnosis and treatment of submucosal neoplasm. Endoscopy combined with laparoscopy
make endoscopic treatments like ESD, ESE, STER become much safer and benefit patients most. |
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