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卓艾综合征(Zollinger-Ellison Syndrome,Z-ES)病人的胃泌素瘤很小,CT扫描和动脉造影等现代化检查技术仍难以作出术前肿瘤定位,内窥镜超声检查(EUS)对此却有明显优势.本文前瞻性研究1989年11月至1993年6月期间的22例Z-ES病人,并对EUS检查定位的敏感性和特异性进行评价.病人与方法:22例ZES病人在术前由CT、上消化道内窥镜和EUS所确诊,计男12例,女10例,平均年龄44.4岁(22到62岁),肝脏转移4例,MENⅠ型综合征5例.所有病人均作上腹部CT、上消化道常规内窥镜和EUS术前肿瘤定位.选择性动脉造影和经肝静脉穿刺活检术(THVS)并不每人都做.上消化道内窥镜和EUS在同天检查,病人在全麻下由两位不知CT和常规内窥镜检查结果,但有丰富内窥镜检查经验的专家进行EUS操作,使用Olympus GFUM_3和GFUM_(20)前视野内窥镜,带用7.5MHz和12MHz两种互换探头.内镜插入十二指肠降部,注射高血糖素,并用一个水囊扩张,使视野清楚,仔细观察十二指肠肠壁,凡有结节隆起都作活检,退至胃内经胃壁检查胶体和胰尾.曾作过胃大部切除Billorth Ⅱ吻合7例不能检查胰头除外,其余所有病例都作了仔细检查.EUS检查后2月内手术,术中仔细触诊胰腺、淋巴结和十二指肠透照检查.切除肿块、清除淋巴结.标本常规作病理和免疫组化检查.对诊断过程作敏感性和?
The gastrinoma in patients with Zollinger-Ellison Syndrome (Z-ES) is very small, modern techniques such as CT scans and arteriography are still difficult to make preoperative tumor localization. Endoscopic ultrasonography (EUS) on this There are obvious advantages. This article prospectively studied 22 cases of Z-ES patients from November 1989 to June 1993 and evaluated the sensitivity and specificity of EUS examination. Patients and Methods: 22 cases of ZES patients Preoperatively confirmed by CT, upper gastrointestinal endoscopy, and EUS, 12 males and 10 females, mean age 44.4 years (22 to 62 years), 4 cases of liver metastases, and 5 cases of MENI-type syndrome. All patients For abdominal CT, conventional endoscopy of the upper gastrointestinal tract, and EUS preoperative tumor localization. Selective angiography and transthoracic puncture biopsy (THVS) are not performed per person. Upper gastrointestinal endoscopy and EUS on the same day Examination, the patient under general anesthesia by two unknown CT and conventional endoscopy results, but has extensive experience in endoscopic examination of the EUS operation, the use of Olympus GFUM_3 and GFUM_ (20) front vision endoscope, with 7.5MHz and 12MHz interchangeable probes. Endoscope inserted into the descending duodenum, injecting glucagon, and using a water bladder Expansion, so that clear vision, carefully observe the duodenal intestinal wall, where there are nodules uplift for biopsy, back to the stomach through the stomach wall to check the colloid and pancreatic tail. Had done for the gastric excision Billorth II anastomosis 7 cases can not check the pancreas Except for the head, all other cases were carefully examined. EUS was performed within 2 months of the examination. The pancreas, lymph nodes, and duodenum were carefully palpated during the operation. The tumor was removed and the lymph nodes were removed. The specimens were routinely used for pathology and immunization. Chemical examination. Sensitivity to the diagnostic process and?