兰州大学机构库 >学院待认领
内镜对上消化道粘膜下肿瘤诊断及治疗价值的临床研究
Alternative TitleClinical research on endoscopic diagnosis and treatment value in submucosal tumors of upper gastrointestinal tract
冯洁
Thesis Advisor黄晓俊
2013-05-14
Degree Grantor兰州大学
Place of Conferral兰州
Degree Name硕士
Keyword上消化道粘膜下肿瘤 超声胃镜 诊断 治疗
Abstract目的:(1)探讨上消化道SMT的一般特征;(2)探讨普通内镜及EUS对上消化道SMT的诊断及治疗价值,内镜下切除上消化道SMT的疗效及安全性。 方法:收集行内镜下诊断,治疗的上消化道SMT75例, 9例行外科手术 治疗,1例静脉瘤未予以治疗,余65例分别行针状刀切开、圈套器切除;粘膜 切除;粘膜剥离。切除标本行常规病理检查,术后定期内镜随访。 结果:(1)75例患者中,男性39例,女性36例;位于食管41、胃部30例,十二指肠4例;直径最大约为4.8cm,最小为0.5cm,直径在2cm内最多见;平滑肌瘤所占比例为52%, GIST占24%;(2)经普通内镜诊断为上消化道SMT 79例,EUS诊断75例,4例为粘膜病变,有病检结果者68例,EUS对6例病变性质诊断错误,75例患者中,9例行外科手术,6例囊肿行开窗引流术,行圈套切除4例,EMR切除25例,ESD切除30例,52例内镜治疗均获得完全切除。5例患者EMR未一次性完整切除病变。1例ESD未一次性完整切除病变。术后8例出现轻度胸骨后疼痛,4例体温增高,5例有恶心症状,均无穿孔发生。除失访的1例患者外,其余病例术后4周复查胃镜,并随访6~24个月不等,未见远期并发症或复发。 结论:(1)上消化道SMT好发于食管,平滑肌瘤最为常见,其次为GIST,男女比例未见明显差别,50-60岁人群常见,无特征性临床表现,小于2cm的良性肿瘤多见,排除肿瘤后,出现吞咽困难,应考虑到食管结核的可能。(2)EUS对于上消化道SMT有很高的诊断价值,并能一定程度上判断SMT性质。(3)内镜下治疗上消化道SMT安全、高效。
Other Abstract[Objective] (1) To investigate the general characteristics of the upper gastrointestinal submucosal tumor; (2) To explore the diagnostic and therapeutic value of the endoscopy and endoscopic ultrasound (EUS), the efficacy and safety of endoscopic resection ways of upper gastrointestinal submucosal tumor. [Method]SMT was diagnosis by ordinary endoscopy, endoscopic ultrasound (EUS), with the consent of the patients and their families, there were 65 cases of patients who willing to treat the tumor with endoscopic, respectively patient with needle-knife resection, direct snare resection, endoscopic mucosal resection ( EMR), endoscopic submucosal dissection (ESD), After that, routine pathological examination of the resected specimens and regular endoscopic follow-up was taken,venous aneurysm were not within endoscopic treatment. [Results] (1) 75 patients, male 39, female 36 cases; located in the esophagus 41 cases, 30 cases of stomach, duodenum 4 cases; maximum diameter was about 4.8cm and minimum diameter was 0.5cm,the diameter of tumor 2cm were so common, leiomyoma account for 52% proportion, stromal tumors accounted for 24%. (2) EUS and pathologic examination confirmed 75 cases , 68 cases had the pathological results, six cases of cysts and one cases of venous aneurysm did not taken pathological examination; 6 cases of lesions were misdiagnosed: two cases of leiomyoma, one case of leiomyosarcoma, one gastrointestinal stromal tumor(GIST), of 75 patients, 9 cases were taken surgery, 65 patients were taken endoscopic treatment ,6 cases of cysts line and create a drainage, 52cases of endoscopic treatment were completely resected for once. 5 cases which did not treat the lesions complete one-time after EMR, 1 case did not resect the lesions completely one-time after ESD. 8 cases had mild retrosternal pain, 4 cases had elevated body temperature, 5 cases had postoperative nausea. All of the cases did not had perforation occurred. all cases had been taken follow-up ranging from 6 to 24 months, and there was no long-term complications or recurrence. [Conclusion](1) Gastrointestinal submucosal tumor is most common in esophageal, Male patients and female incidence is no significant difference; the tumor’s clinical symptom is not obvious. Have difficulty swallowing, esophageal tuberculosis should be considered.(2) Endoscopic ultrasonography for upper gastrointestinal submucosal tumor has high diagnostic value.(3)Endoscopic treatment of SMT is safe and effect...
URL查看原文
Language中文
Document Type学位论文
Identifierhttps://ir.lzu.edu.cn/handle/262010/222943
Collection学院待认领
Affiliation临床医学院
Recommended Citation
GB/T 7714
冯洁. 内镜对上消化道粘膜下肿瘤诊断及治疗价值的临床研究[D]. 兰州. 兰州大学,2013.
Files in This Item:
There are no files associated with this item.
Related Services
Recommend this item
Bookmark
Usage statistics
Export to Endnote
Altmetrics Score
Google Scholar
Similar articles in Google Scholar
[冯洁]'s Articles
Baidu academic
Similar articles in Baidu academic
[冯洁]'s Articles
Bing Scholar
Similar articles in Bing Scholar
[冯洁]'s Articles
Terms of Use
No data!
Social Bookmark/Share
No comment.
Items in the repository are protected by copyright, with all rights reserved, unless otherwise indicated.