胃脂肪瘤的超声内镜诊断及治疗

目的:评价超声内镜用于诊断并治疗胃脂肪瘤的临床价值。方法:2005年至2011年胃镜检查发现的胃隆起性病变317例,经超声内镜检查,对初步诊断为胃脂肪瘤且直径小于2cm者行橡皮圈套扎联合高频电切,切除后的瘤体送病理检查。结果:317例胃隆起性病变中,超声内镜初步诊断胃脂肪瘤28例,其中24例(85.7%)经病理确诊。24例中直径小于2cm的胃脂肪瘤20例,经内镜引导下治疗,术后2个月复查胃镜,其中直径小于1.2cm的18例胃脂肪瘤完全消失,直径1.2～2.0cm的2例脂肪瘤部分残留,治愈率为90.0%。结论:超声内镜诊断胃脂肪瘤具有无创、准确的优点;超声内镜引导下橡皮圈套扎联合高频电切治疗直径小于1.2cm的胃脂肪瘤安全、有效。

Diagnosis and treatment of gastric lipoma with endoscopic ultrasonography

Aim:To assess the value of endoscopic ultrasonography(EUS) in the diagnosis and treatment of gastric lipoma.Methods:A total of 317 cases of protuberances diagnosed by stomach endoscopy from 2005 to 2011 were examined by EUS.Initial diagnosis and diameter less than 2 cm of gastric lipoma were treated by endoscopic elastic band ligation combined high frequency electrosection and the samples were sent for pathological examination.Results:Twenty-eight out of 317 cases were diagnosed as gastric lipoma by EUS,among which,24(85.7%) cases were diagnosed as lipoma by pathological examination.Gastric lipomas with diameter less than 2 cm(20 cases) were treated by endoscopic elastic band ligation combined high frequency electrosection,among which,18 cases with diameter less than 1.2 cm completely healed,and 2 cases with diameter larger than 1.2 cm had residual tumor by follow-up endoscopy after two months,and the cure rate was 90.0%.Conclusion:EUS is an effective method for diagnosing gastric lipoma,and it is non-invasive and accurate.Endoscopic elastic band ligation combined high frequency electrosection is efficient and safe for treating gastric lipoma with diameter less than 1.2 cm.