摘要
目的探讨内镜下高频电切除胃底巨大平滑肌瘤的可行性和安全性 .方法本组共 4例 ,胃镜证实为胃底巨大平滑肌瘤 ,大小分别为 4 cm× 4 cm、 4 cm× 5 cm、 5cm× 5 cm、 5 cm× 6 cm.内镜下用高频电圈套器套扎前 ,先在瘤体基底部黏膜下注射适量 50%葡萄糖溶液 ,然后放电切除平滑肌瘤 .对 1例切除不理想者 ,于残瘤侧分点注射无水酒精 ,每周 1次 ,共 2次 .结果 3例一次性套扎切除成功；另 1例需补注射无水酒精者 , 2月后胃镜复查发现残瘤体已脱落 .本组病例经病理证实均为平滑肌瘤 .本疗法并未出现明显的副作用或并发症 .结论内镜下高频电切除对胃底巨大平滑肌瘤是有效的 .在瘤体基底部注射高渗葡萄糖 ,可避免长时间电切导致的胃穿孔 .
Objective To evaluate the feasibility and security of excising huge leiomyoma of gastric fundus by high frequent electrocut under endoscope.Methods Four cases with huge leiomyoma of gastric fundus were confirmed by gastroscope. The sizes of these tumors were 4 cm× 4 cm,4 cm× 5 cm, 5cm× 5 cm, 5 cm× 6 cm respectively. At first , 50% glucose solution was injected into the base of tumor body, then high frequent electric snare was used for snaring and ligation, finally leiomyoma was excised by releasing electricity. One tumor was too big to be excised completely, so pure alcohol was injected at several points of residual tumor once a week for two weeks.Results Three cases were excised successfully in one time. The residual tumor of another case, receiving pure alcohol injection, disappeared under gastroscope two months later. Samples of 4 cases were confirmed as leiomyoma pathologically. No side- effect and complication was found in this technique.Conclusions High frequent electrocut under endoscope is effective on huge leiomyoma of gastric fundus. Gastric perforation induced by long time electrocut can be avoided by means of the injection of hypertonic glucose solution into the base of huge leiomyoma.
关键词
内镜
电外科手术
平滑肌瘤
胃底
Endoscope
Electrosurgery
Leiomyoma
Gastric fundus
