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[目的]观察内镜下注射无水酒精+平阳霉素治疗平滑肌瘤的疗效。[方法]经内镜检查出黏膜下肿瘤,再行超声内镜检查证实为平滑肌瘤,患者群体分为2组:A组无水酒精+平阳霉素注射组、B组:ESD术+外科手术组。A组:根据瘤体的大小控制无水酒精+平阳霉素注入的总量,对于瘤体较大的可进行间隔2、3次治疗,较小的可一次治愈。B组:ESD术+外科行手术治疗。所有患者均在治疗后2个月、半年,至治疗后1-9年不等复查,了解患者症状及瘤体有无复发,并在疗效、住院天数两方面比较优劣。[结果]A组:所有患者无一例穿孔、出血等并发症出现,住院天数平均为10.5d,复查胃镜未见复发。B组:1例患者出现术后感染,无一例穿孔、出血等并发症出现,住院天数平均为17.5d,复查胃镜未见复发。[结论]内镜下注射无水酒精+平阳霉素治疗平滑肌瘤疗效确切,随访观察1~9年不等未见复发,患者症状消失,无水酒精可使肿瘤组织脱水、凝固坏死、纤维化和微血管闭塞,平阳霉素可抑制DNA的合成,干扰其新陈代谢,抑制肿瘤生长,两药合用可使肿瘤愈后近远期疗效较好、肯定,避免创伤大、穿孔等并发症的发生,方法简便,易于推广,在治疗风险及住院天数方面优于ESD术+外科手术组。
[Objective] To observe the efficacy of endoscopic injection of anhydrous alcohol + pingyangmycin in the treatment of leiomyoma. [Method] The submucosal tumors were detected by endoscopy and leiomyoma was confirmed by endoscopic ultrasonography. The patients were divided into two groups: group A with alcohol + pingyangmycin injection, group B with ESD + surgery Surgery group. Group A: according to the size of the tumor control anhydrous alcohol + Pingyangmycin injection of the total, larger for the tumor can be 2,3 times interval treatment, the smaller one can be cured. Group B: ESD surgery + Surgical treatment. All patients were in 2 months after treatment, six months, ranging from 1 to 9 years after treatment review, to understand the symptoms and tumor recurrence, and efficacy, length of stay in two aspects of the merits. [Result] Group A: All patients had no case of perforation, complications such as bleeding appeared, the average number of days of hospitalization was 10.5d, and no recurrence was found by gastroscopy. Group B: 1 patient had postoperative infection, no case of perforation, bleeding and other complications, the average number of days of hospitalization was 17.5d, no recurrence of gastroscopy. [Conclusion] Endoscopic injection of absolute alcohol + pingyangmycin for the treatment of leiomyoma has definite curative effect. Follow-up observation of 1-9 years of follow-up showed no recurrence. Patients’ symptoms disappeared. Dehydration of tumor tissue, coagulation and necrosis, fibrosis Pingyangmycin can inhibit the synthesis of DNA, interfere with its metabolism, inhibit tumor growth, the combination of the two drugs can make the tumor near and long-term better curative effect, affirmation, to avoid trauma, perforation and other complications, The method is simple, easy to popularize, and is superior to ESD + surgery in terms of treatment risk and length of stay.