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双气囊小肠镜诊断小肠间质瘤致消化道出血的价值[J]. 肿瘤防治研究, 2015, 42(02): 177-180. DOI: 10.3971/j.issn.1000-8578.2015.02.017
引用本文: 双气囊小肠镜诊断小肠间质瘤致消化道出血的价值[J]. 肿瘤防治研究, 2015, 42(02): 177-180. DOI: 10.3971/j.issn.1000-8578.2015.02.017
Value of Double-Balloon Enteroscopy in Diagnosing Alimentary Tract Hemorrhage Induced by Stromal Tumor of Small Bowel[J]. Cancer Research on Prevention and Treatment, 2015, 42(02): 177-180. DOI: 10.3971/j.issn.1000-8578.2015.02.017
Citation: Value of Double-Balloon Enteroscopy in Diagnosing Alimentary Tract Hemorrhage Induced by Stromal Tumor of Small Bowel[J]. Cancer Research on Prevention and Treatment, 2015, 42(02): 177-180. DOI: 10.3971/j.issn.1000-8578.2015.02.017

双气囊小肠镜诊断小肠间质瘤致消化道出血的价值

Value of Double-Balloon Enteroscopy in Diagnosing Alimentary Tract Hemorrhage Induced by Stromal Tumor of Small Bowel

  • 摘要: 目的 探讨小肠间质瘤致消化道出血患者双气囊小肠镜检查(double balloon enteroscope, DBE)的诊断价值及小肠间质瘤内镜下形态学特点。 方法 回顾性分析40例小肠间质瘤致消化道出血患者的临床表现、内镜下形态、肿瘤大小、肿瘤位置、影像学检查及手术病理结果等资料。结果 小肠间质瘤致消化道出血多见于中老年人平均年龄(50.50±10.21)岁,以黑便、血便或大便隐血阳性为主要特征,多伴有贫血、腹痛、腹胀、体重下降等症状。15.00%(6/40)患者双气囊小肠镜检查前通过腹部CT、血管造影等检查发现病灶。95.00%(38/40)小肠间质瘤病灶经小肠镜发现,5.00%(2/40)首次检查漏诊。小肠间质瘤内镜下表现为边界清楚、质地较硬的半球形或球形黏膜下隆起,黏膜完整或出现浅表糜烂,肠腔狭窄或部分狭窄。手术后评估极低危险度6例,低危险度15例,中等危险度13例,高危险度6例。 结论 DBE是一种安全、准确诊断小肠间质瘤的检查方法,但无法确诊并准确评估其侵袭危险程度和临床预后。如何结合其他诊断信息争取早期发现并准确评估其临床预后值得进一步研究。

     

    Abstract: Objective To investigate the diagnostic value of double balloon enteroscopy(DBE) in diagnosing alimentary tract hemorrhage induced by stromal tumor of small bowel(STSB) and analyze the morphological features of small bowel under endoscopy. Methods We retrospectively analyzed the clinical manifestation, endoscopic appearance, tumor size, location, imageological characteristics and postoperative pathological diagnosis data of 40 patients with alimentary tract hemorrhage induced by STSB. Results Alimentary tract hemorrhage induced by STSB was more common in the elderly (50.50±10.21) year-old) , with melena, bloody stool or positive in occult test as the main characteristics, and mostly suffered from anemia, abdominal pain, distension and loss of body weight. Lesion was detected by abdomen CT or angiography prior to DBE in 15.00% (6/40) of patients; 95.00% (38/40) stromal tumor of small intestine was detected by DBE; 5.00%(2/40) of the patients was missed diagnosis. Stromal tumor appeared as hard, spherical or hemispherical submucosal protrusion with clearly demarcated borders. The mucosal was intact or of superficial erosion, with part of luminal narrowing. Risk factors were defined after the operation: very low risk (6 cases), low risk (15 cases), intermediate risk (13 cases) and high risk (6 cases). Conclusion DBE is an effective and safe method for identifying STSB, however, it still has limitations in evaluating the invasion risk and clinical prognosis. For early detection, accurate clinical evaluation and prognosis of STSB combined with other diagnostic information, further studies will be needed.

     

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