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目的 :探讨内镜超声检查在上消化道隆起性病灶诊断中的价值。方法 :应用OLYMPUSEU -M 30 ,GF -UM2 0 0型 ,7.5/ 1 2MHz超声内镜对 32 2例内镜提示上消化道隆起性病灶 ,部分甚至结合活检仍无法确诊者进行内镜超声检查 ,并分析检查结果。结果 :32 2例上消化道隆起性病灶中 ,以胃的隆起性病灶最多 (1 98例 ) ,其他依次为食道 (95例 )、十二指肠 (2 3例 )和贲门 (6例 )。病变性质以良性病变为主 ,共检出平滑肌瘤 1 2 1例(位于固有肌层 83例、黏膜肌层 38例 ) ,其它依次为恶性肿瘤 53例、外压性病变 50例 (其中胃底 2 0例、脾脏外压 1 4例 )、未发现病变 2 3例、异位胰腺 2 0例 (胃窦 1 5例 )、血管性病变 1 6例、息肉 1 1例、炎症 9例、消化道壁增厚 8例、囊肿与脂肪瘤各 5例、纤维瘤 1例。恶性病变及部分良性病变获组织学证实。结论 :内镜超声检查能贴近病变部位进行扫描 ,能清楚地显示消化道壁的层次结构 ,对上消化道隆起性病灶具有准确的定位作用 ,并能较好地提示病变的性质 ,对明确上消化道隆起性病灶的诊断及指导治疗 ,具有较高的价值。但在肌瘤的良恶性判断上存在着一定的困难。
Objective: To investigate the value of endoscopic ultrasonography in the diagnosis of elevated digestive tract lesions. Methods: Endoscopic ultrasonography was performed on 32 2 cases of endoscopic upper extremity lesions revealed by OLYMPUSE U-M 30, GF -UM 2000 and 7.5 / 1 2MHz endoscopic ultrasonography. Some of them were even diagnosed by biopsy. And analyze the test results. Results: Among the 32 cases of upper digestive tract lesions, the largest number of gastric uplift lesions were found (98 cases), followed by the esophagus (95 cases), the duodenum (23 cases) and the cardia (6 cases) . A total of 121 cases of leiomyoma were found (83 in muscularis propria and 38 in muscularis mucosa). The others were malignant tumor followed by 53 cases of external tumor and 50 cases of external pressure disease At the end of 20 cases, splenic external pressure of 14 cases), no lesions found in 23 cases, 20 cases of heterotopic pancreas (gastric antrum 15 cases), vascular lesions in 16 cases, 11 cases of polyps, inflammation in 9 cases, Gastrointestinal wall thickening in 8 cases, 5 cases of cysts and lipoma, 1 case of fibroma. Malignant lesions and some benign lesions confirmed by histology. Conclusion: Endoscopic ultrasonography can be performed close to the lesion site, clearly showing the hierarchy of the digestive tract wall and accurately locating the uplift lesions of the upper digestive tract, and can better indicate the nature of the lesion. Digestive tract lesions diagnosis and guidance, has a high value. However, there are some difficulties in judging the benign and malignant myomas.