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目的探讨微探头超声内镜(miniprobe endoscopic ultrasonography MEUS)在胃平滑肌瘤诊断中的应用价值。方法对125例胃黏膜下隆起性病变行微探头超声内镜检查,在MEUS检查前均经胃镜检查并发现胃内有隆起性病变,但诊断未能确定。对76例MEUS诊断为胃平滑肌瘤的病例均行内镜下治疗,术后标本送病理检查。将胃镜、MEUS及病理结果进行比较。结果超声内镜诊断胃平滑肌瘤76例,其中病变起源于黏膜肌层62例,给予内镜下黏膜下切除术治疗;起源于固有肌层14例,给予内镜下黏膜下剥离术治疗。病变位于胃底部14例,胃体部28例,胃窦部34例;直径<2cm 64例,>2cm 12例。76例患者均成功切除病变,7.5MHZ适合于显示病灶内部回声,12MHZ显示病灶起源较清楚。病理均提示为胃平滑肌瘤,其起源层次与超声内镜诊断结果一致,超声内镜检查准确率为100%。结论微探头超声内镜可清晰显示胃平滑肌瘤的病变层次结构,根据其诊断结果对胃平滑肌瘤行内镜下治疗是一种安全、有效、创伤小的治疗方法。
Objective To investigate the value of miniprobe endoscopic ultrasonography (MEUS) in the diagnosis of gastric leiomyoma. Methods 125 cases of submucosal humeral bump lesions were examined by sonar endoscopy. Before MEUS examination, gastroscopy was used to detect the presence of bulging lesions in the stomach, but the diagnosis was not confirmed. 76 cases of MEUS diagnosed as gastric leiomyoma cases were treated with endoscopy, postoperative specimens sent for pathological examination. Gastroscopy, MEUS and pathological results were compared. Results Ultrasound endoscopy diagnosis of gastric leiomyoma 76 cases, of which lesions originate in 62 cases of mucosal muscular layer, given endoscopic submucosal resection; originated in the muscularis muscle in 14 cases, given endoscopic submucosal dissection. Lesions in the stomach at the bottom of 14 cases, 28 cases of gastric body, gastric antrum in 34 cases; diameter <2cm 64 cases,> 2cm 12 cases. 76 patients were successfully removed the lesion, 7.5MHZ suitable for displaying internal lesion, 12MHZ showed that the origin of the disease more clearly. Pathology were prompted for gastric leiomyoma, its origin level and endoscopic diagnostic ultrasound results, ultrasound endoscopy accuracy was 100%. Conclusion Micro-probe endoscopic ultrasonography can clearly show the pathological changes of gastric leiomyoma. According to its diagnostic results, endoscopic treatment of gastric leiomyoma is a safe, effective and small trauma treatment.