黑斑息肉综合征6例的诊治分析

目的 探讨黑斑息肉综合征（PJS）的诊断和治疗方案.方法 对1996年3月～2006年3月收治的6例PJS患者的临床资料进行回顾性分析.结果 6例均有皮肤、黏膜色素沉着和胃肠道多发性息肉,其中非手术治疗2例,外科手术4例,其中纤维结肠镜电切1例,套叠式纤维内镜（从肠壁切口进镜）电切治疗1例,最长随访时间3年,6例患者均无再行手术者.结论 PJS患者息肉症状轻,息肉直径小于2 cm无须手术治疗;胃、十二指肠及结肠的息肉可在胃镜、结肠镜下高频电切;多段肠道（特别是空、回肠）的多发性息肉,宜行胃镜、肠镜结合术中肠镜及“套叠式”息肉摘除法,尽量避免胃肠部分切除.对PJS患者的胃肠道和其他有可能恶变的脏器应进行随访.

The Study of the Diagnoses and Therapy for 6 Cases of Peutz-Jeghers Syndrome

Objective To investigate the diagnostic methods and therapy for patients with Peutz-Jeghers syndrome (PJS).Methods Clinical data of 6 patients admitted to Jiujiang First People Hospital between 1996 and 2006 were analyzed retrospectively.Results All the 6 cases were with the multiple polypus in gastrointestinal tract and mucocutaneous pigmentation.2 cases were treated by expectant treatment; 4 cases were treated with operation.1 case was resected under fiberoptic endoscope; And 1 case was applied with intraoperative endoscope and we got good therapeutic effect.Among all the patients the longest follow-up time was 3 years and no operation was applied again.Conclusion Expectant treatment can be applied for patients with PJS which the polypi are no more than 2.0 cm with no severe symptom.Incision under fiberoptic endoscope can be applied for polypi in the stomach,duodenum or colon.The intraoperative endoscope is appropriate to the multiple polypi in intestinal tracts (especial in the jejunum and ileum),and it can avoid of gastrointestinal tracts resection.Follow-up is indispensable to the patients with PJS which there is canceration in the gastrointestinal tracts or other organs.