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目的 探讨食管微小平滑肌瘤的临床特点及高频电切除治疗的价值。方法 2 0 0 1年 3月～ 2 0 0 3年 3月 ,我院高频电切除治疗食管微小平滑肌瘤共 39例 ,对其临床及治疗资料进行分析。结果 食管微小平滑肌瘤以男性患者多见 ,男女性比例 2 .2 5∶1。好发年龄 30～ 6 5岁 (33/ 39,84 .6 % )。临床症状以吞咽困难或进食不畅感 (2 2 / 39,5 6 .4 % )、上腹部疼痛或不适 (2 0 / 39,5 1.3% )、胸骨后不适 (12 / 39,30 .8% )等多见。肿瘤多位于食管中段 (18/ 39,4 6 .2 % )、下段 (17/ 39,4 3.6 % ) ,尤以食管第二生理性狭窄以下多见 (32 / 39,82 .1% )。形态以圆形或椭圆形多见 (34/ 39,87.2 % ) ,广基 (38/ 39,97.4 % ) ,表面光滑 (34/ 39,87.2 % ) ,质硬 (37/ 39,94 .9% ) ,活动度好 (39/ 39,10 0 % ) ,大小平均为 0 .98± 0 .2 8cm。 6例患者超声胃镜声像显示病变多位于超声第 2层 ,低回声、不均匀回声多见 ,境界较清楚。 39例患者术后无食管穿孔、食管狭窄等严重并发症发生 ,创面渗血 1例 (1/ 39,2 .6 % ) ;术后 1月～ 2年复查电子胃镜未见病变再发。结论 食管微小平滑肌瘤早期临床表现多非特异 ;内镜下高频电切除治疗是一种安全、有效的治疗手段
Objective To investigate the clinical features of esophageal leiomyoma and the value of high frequency electrotomy. Methods From March 2001 to March 2003, 39 cases of esophageal leiomyomata were treated by high frequency electrotomy in our hospital. The clinical and therapeutic data were analyzed. Results Esophageal leiomyoma more common in men, male and female ratio of 2. Good hair age 30 ~ 6 5 years old (33 / 39,84 .6%). Clinical symptoms included dysphagia or poor feeding (22/39, 56.4%), upper abdominal pain or discomfort (20/39, 53%), post-sternal discomfort (12/39, 30.8 %) And other more common. The tumors were mostly in the middle of the esophagus (18/39, 42.6%) and in the lower (17/39, 43.6%), especially in the second esophageal sphincter (32/39, 82.1%). Morphology is more common in round or oval (34/39, 87.2%), wide base (38/39, 97.4%), smooth surface (34/39, 87.2% %), Activity was good (39/39, 10%), the average size of 0.98 ± 0.28cm. Ultrasound gastroscopy in 6 patients showed that lesions were located in the second layer of ultrasound, hypoechoic, uneven echo more common, the state more clearly. 39 cases of patients without esophageal perforation, esophageal stenosis and other serious complications, wound bleeding in 1 case (1 / 39,2. 6%); 1 month ~ 2 years after the review of electron endoscopy no recurrence of lesions. Conclusion The early clinical manifestations of esophageal leiomyoma are mostly unspecific. High-frequency endoscopic resection is a safe and effective treatment