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目的探讨超声引导下胃肠道病变穿刺活检的临床应用价值。方法对30例经肠镜、CT或MRI检查发现但未能明确诊断的胃肠道病变(胃来源2例、小肠4例、结肠4例、直肠18例、肛管2例)进行超声引导下穿刺活检,总结活检方法、成功率及相关并发症。结果 30例中,经腹穿刺10例,经直肠穿刺16例,经肛周穿刺4例。标本取材满意29例,目标病灶穿刺成功率96.67%(29/30)。29例取材成功者中,活检病理提示良性病变11例,恶性病变18例,其中7例手术切除,6例活检病理与手术病理相符,1例活检病理不能鉴别未分化癌与间皮瘤,手术病理证实为未分化癌,其余病例与随访结果相符。穿刺后随访1~18个月,所有患者均未出现穿刺相关并发症。结论对于胃肠道病变,尤其是内镜活检困难或无效的病变,超声引导穿刺活检是安全、有效的诊断方法。
Objective To investigate the clinical value of ultrasound-guided gastrointestinal lesion biopsy. Methods Thirty patients with gastrointestinal lesions (2 gastric origin, 4 small intestine, 4 colon, rectum 18, anal canal 2) found by enteroscopy, CT or MRI but not yet diagnosed under the guidance of ultrasound were enrolled. Biopsy, summarize the biopsy method, the success rate and related complications. Results 30 cases of abdominal puncture in 10 cases, rectum puncture in 16 cases, perianal puncture in 4 cases. Specimens were taken from 29 patients, the success rate of the target lesion was 96.67% (29/30). Among the 29 cases, biopsy showed benign lesions in 11 cases and malignant lesions in 18 cases, of which 7 cases were surgically resected and 6 cases biopsy were consistent with the surgical pathology. One case of biopsy did not distinguish between undifferentiated carcinoma and mesothelioma, Pathological confirmed as undifferentiated carcinoma, the rest of the cases and follow-up results. All cases were followed up for 1 to 18 months after puncture. No puncture-related complications occurred in all patients. Conclusion Ultrasound-guided biopsy is a safe and effective diagnostic method for gastrointestinal lesions, especially those with difficult or ineffective endoscopic biopsy.