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目的评价内镜超声在消化道黏膜下肿瘤的诊断及治疗中的价值。方法对内镜检查中怀疑黏膜下肿瘤者进行内镜超声检查,根据黏膜下肿瘤的起源层次及性质决定治疗方案,内镜治疗包括内镜下黏膜切除术、黏膜剥离-肿瘤摘除术、高频电切术及硬化治疗。结果73例良性间质瘤起源于黏膜肌层,7例直肠类癌位于黏膜固有层;脂肪瘤13例、异位胰腺17例、胃底静脉曲张5例、囊肿6例起源于黏膜下层;95例良性间质瘤及21例恶性间质瘤起源于固有肌层,1例类癌侵及固有肌层。61例源于黏膜肌层及8例源于固有肌层的良性间质瘤、8例脂肪瘤、8例异位胰腺及7例类癌经内镜切除,4例囊肿行内镜下穿刺治疗;33例源于固有肌层的良性间质瘤、18例恶性间质瘤、2例脂肪瘤、2例异位胰腺及1例类癌经手术切除。病理符合率为97·97%。结论超声内镜能够对消化道黏膜下肿瘤进行起源和定性诊断,对黏膜下肿瘤治疗方案的选择具有重要的指导意义。
Objective To evaluate the value of endoscopic ultrasonography in the diagnosis and treatment of gastrointestinal submucosal tumors. Methods Endoscopic ultrasonography was performed on suspected submucosal tumors in endoscopy. According to the origin and quality of submucosal tumors, the treatment regimen was decided. Endoscopic treatment included endoscopic mucosal resection, mucosal dissection - tumor excision, high frequency Electrical resection and sclerotherapy. RESULTS: Totally 73 cases of benign stromal tumors originated from the muscularis mucosa and 7 cases of rectal carcinoids located in the lamina propria. 13 cases of lipoma, 17 cases of ectopic pancreas, 5 cases of gastric varices and 6 cases originated from the submucosa. 95 The cases of benign stromal tumors and 21 cases of malignant stromal tumors originated in the muscularis propria, one case of carcinoid invasion and muscularis propria. Sixty-one cases of benign stromal tumors originated from the muscularis mucosa and 8 from the muscularis propria, 8 cases of lipoma, 8 cases of ectopic pancreas and 7 cases of carcinoid tumors were resected by endoscopy, and 4 cases of cyst were treated by endoscopic puncture ; 33 cases of benign stromal tumors derived from the muscularis propria, 18 cases of malignant stromal tumors, 2 cases of lipoma, 2 cases of ectopic pancreas and 1 case of carcinoid tumor resection. The coincidence rate of pathology was 97.97%. Conclusion Endoscopic ultrasonography can diagnose the origin and the qualitative diagnosis of submucosal tumors of the digestive tract, which has important guiding significance for the choice of treatment options for submucosal tumors.