消化内镜下胃肠道早期肿瘤诊断与治疗.docVIP

消化内镜下胃肠道早期肿瘤诊断与治疗 　　【摘 要】随着消化内镜技术的发展,胃肠道早期肿瘤的诊断与治疗得到长足的发展。现将近年来相关文献诊治进展作简单综述。诊断方面:①定期内镜检查及病理是公认必要进行的步骤。②超声内镜对粘膜下病变及邻近腔外病变的诊断价值也达成共识。③色素内镜就是对所要观察的病灶进行染色后在内镜下观察其粘膜结构、腺管开口、组织上皮微血管结构,从而实现对早期肿瘤的诊断,目前常用的染色剂为卢戈氏液、美兰、亚甲兰及靛胭脂。④放大内镜。有研究表明其对早期癌诊断的敏感性和特异性分别可达96%和95.5%。放大内镜常和色素内镜联合检查,可更清晰地辩别组织形态结构,提高早期癌的诊断率。⑤自发荧光技术(AF)。⑥NBI(窄波显像技术)。色素内镜、AF及NBI现在均与放大内镜有机地结合起来,且上述技术的最终目标均为清晰地显示病灶表层小凹结构、血管增生情况及腺管开口、绒毛结构,从而诊断早期癌。治疗方面:内镜下治疗大致上分为腹腔镜手术及组织破坏法和粘膜切除法。腹腔镜治疗在此不再赘述.组织破坏法:①微波凝固治疗。②激光治疗和光动力疗法。③氩离子凝固术(argon plasma coagulation,APC)。④内镜下冷冻治疗(cryoablation)。粘膜切除法:①内镜下黏膜切除术(Endoscopic mucosal resection,EMR)。②内镜粘膜下切割术(Endoscopic submucosal dissection,ESD)。 　　【关键词】 消化内镜 消化道早期肿瘤 诊断治疗 　　Diagnosis and treatment for gastrointestinal tract early cancer under endoscopy 　　He Wei 　　【Abstract】 Along with digest inside the technical development of mirror, the diagnosis and treatments of the tumor of an earlier period of stomach and intestines get the substantial development.Makes a diagnosis and give treatment related cultural heritage in recent years to make progress to make the simple overview now.Examine a patient the aspect :①Periodical inside the mirror check and the pathology is the step that the generally accepted necessity carry on.②The super mirror inside the voice reaches the consensus towards gluing the film descend the diagnosis value of the pathological changes and close by antrum outside pathological changes also.③ Dye inside mirror be to to observe of focus after carry on the dyeing observe under inside the mirror it glue the film structure, the gland tube openings, organization up the skin capillaries structure, thus carrying out the diagnosis of the tumor toward the earlier period, the in common use dye is the indigo rouges etc currently.④Enlarge inside the mirror.Has the research to express it examines a patient to the cancer of the earlier period of sensitivity and particularity can amount to 96% and 95.5%s respectively.Enlarge to often unite the check with mirror inside the dye inside