内镜下注射无水酒精+平阳霉素治疗消化道平滑肌瘤的临床应用

目的应用无水酒精+平阳霉素注射治疗平滑肌瘤,可避免外科手术治疗带来的创伤及内镜下透明帽剥离法、高渗盐水注射法、高频电圈套切除平滑肌瘤致穿孔的危险,探讨它的优缺点。方法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,所有患者均在注药后2个月、0.5a复查。结果所有患者2个月后复查肿瘤部位已完全平坦,部分可见疤痕,0.5a后复查未见复发,对于较小的瘤体病人注药后无不适症状,瘤体较大者可有腹痛,给予对症治疗后缓解。结论内镜下注射无水酒精+平阳霉素治疗平滑肌瘤,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,避免创伤大、穿孔等并发症的发生。

Clinical application of endoscopic injection of absolute alcohl + Pingyangmycin hydrochloride to treat enteron leiomyoma

Objective] When applying absolute alcohl+Pingyangmycin hydrochloride to treat enteron leiomyoma, in order to avoid the trauma caused by surgical therapy and the risk induced by endoscopic lucency cap desquamation, ultra isotonic brine injection and high frequency electrical trap excision of leiomyoma, to discuss the adventages and disadvantages of the treatment. Methods] The injection gross of alcohl+Pingyangmycin hydrochloride was controlled based on the size of the leiomyoma. The biggish were proceeded 2, 3 treatment with interval, the lesser once. All the patients were callback at 2 and 6 month after the injection. Results] The tumor position of all had been observed smooth completely, and some have remained scar. No recrudescence was found in 6-month callback. When under this treatment, patients with lesser tumor had no discomfort, while patients with biggish one might have bellyache which could be eased by allopathy. Conclusion] When using endoscopic injection of absolute alcohl + Pingyangmycin hydrochloride to treat enteron leiomyoma, absolute alcohl is able to rend the tumor become dehydrated, solidification, necrosis, fibrosis and microvessel occlusion, and Pingyangmycin hydrochloride is able to restrain the synthesis of DNA, to disturb the metabolism of leiomyoma cells and to restrain tumor development. Using the two can benefit the near and far curative effect and avoid complication such as considerable wound and perforation.