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目的探讨超声微探头(MPS)对消化道黏膜下隆起病变的诊断正确率和MPS提供的诊断资料对内镜医师选择治疗方式的参考价值。方法对消化道黏膜下隆起病变进行内镜下超声微探头检查,根据隆起的大小、性质和在管壁的层次等超声资料来诊断黏膜下隆起病变并选择切除方法。结果在24例患者中,对MPS诊断位于黏膜下层以上的直径小于2cm的消化道黏膜下肿块11例(良性间质瘤2例,脂肪瘤3例,囊肿5例,食管颗粒细胞瘤1例)采用内镜下治疗(黏膜切除术、氩离子体凝固治疗),无出血、穿孔并发症。对于MPS诊断直径2cm以上或位于固有肌层以下的消化道黏膜下肿块13例(恶性胃肠道间质瘤4例,良性胃肠道间质瘤6例,脂肪瘤1例,异位胰腺2例)行外科手术。其超声诊断与病理诊断结果相一致。结论 MPS可诊断黏膜下隆起的大小、层次和性质,有助于选择适应内镜下治疗的黏膜下隆起病例,内镜下治疗位于黏膜下层以内直径小于2cm的消化道黏膜下肿块SMT是安全、有效的方法。
Objective To investigate the diagnostic value of ultrasonic microprobe (MPS) in diagnosis of submucosal uplift of digestive tract and the diagnostic value provided by MPS for the reference of endoscopic treatment. Methods The submucosal uplift lesions of the digestive tract were examined by endoscopic ultrasonography, and the submucosal swelling lesions were diagnosed according to the size and nature of the bulge and the level of the wall of the digestive tract, and the excision method was selected. Results Among the 24 patients, 11 cases of gastrointestinal submucosal tumors with diameter less than 2 cm (2 benign stromal tumors, 3 lipomas, 5 cysts and 1 esophageal granulosa cell tumor) were located in the submucosa of MPS. Endoscopic treatment (mucosal resection, argon ion coagulation therapy), no bleeding, perforation complications. For the diagnosis of MPS diameter of 2cm or more in the muscularis mucosa of the lower gastrointestinal tract in 13 cases (4 cases of malignant gastrointestinal stromal tumors, 6 cases of benign gastrointestinal stromal tumors, lipoma in 1 case, ectopic pancreas 2 Example) Surgical operation. Its ultrasound diagnosis and pathological diagnosis consistent. Conclusions MPS can diagnose the size, level and nature of submucosal uplift, which is helpful to choose the submucosal uplift that can be adapted to endoscopic treatment. Endoscopic treatment of gastrointestinal submucosal mass with sub-submucosa diameter less than 2cm is safe, effective method.