摘要
目的探讨运用双钳道胃镜在内镜下全层切除术治疗胃黏膜下肿瘤封闭穿孔中的应用价值。方法选择43例起源于固有肌层及以下的胃黏膜下肿瘤行内镜下全层切除术治疗,选择双钳道胃镜(双钳道组)或者尼龙绳辅助金属夹(尼龙绳组)进行闭合穿孔,比较两组治疗效果。结果43例患者全部顺利完成内镜下全层切除术,两组在年龄、性别、肿瘤直径、穿孔直径方面差异均无统计学意义(P>0.05)。双钳道组在封闭过程中钛夹使用数量为(6.00±1.78)个,尼龙绳组为(7.20±1.32)个(t=-2.47,P<0.05)。双钳道组封闭耗时为(16.17±6.03)min,尼龙绳组为(21.10±6.35)min(t=-2.60,P<0.05)。两组术后并发症比较,差异无统计学意义(P>0.05)。双钳道组术后住院天数为(6.26±1.51)d,尼龙绳组为(7.27±1.03)d(t=-2.07,P<0.05)。双钳道组住院总费用为(25312.32±4960.79)元,尼龙绳组(27836.26±1974.21)元(t=-2.52,P<0.05),两组在术后开放饮食时间及抗生素使用天数方面均无统计学意义(P>0.05)。结论应用双钳道胃镜行内镜下全层切除术治疗起源于固有肌层及以下的胃黏膜下肿物安全实用,创伤小,费用低,疗效满意,值得临床推广应用。
Objective To discuss the application value of using the double clamp channel endoscope in the endoscopic full-thickness resection(EFR)for the treatment of gastric submucosal tumor with closed perforation.Methods Forty-three cases of gastric submucosal tumors originating from the lamina propria and below were treated with EFR retrospectively.Double-clamp gastroscopy(double-clamp gastroscopy group)or nylon rope-assisted metal clip(nylon rope group)were selected to perform closed perforation.The therapeutic effects of the two groups were compared.Results EFR was successfully completed in all 43 patients.There was no significant difference in age,sex,tumor diameter and perforation diameter between the two groups(P>0.05).The number of titanium clips used in the two-pliers group was(6.00±1.78)and that in the nylon rope group was(7.20±1.32)(t=-2.47,P<0.05).The closure time of the two-pliers group was(16.17±6.03)min and that of the nylon rope group was(21.10±6.35)min(t=-2.60,P<0.05).There was no significant difference in postoperative complications between the two groups(P>0.05).The hospitalization days in the two-pliers group were(6.26±1.51)days,and in the nylon rope group were(7.27±1.03)days(t=-2.07,P<0.05).The total hospitalization expenses in the two-pliers group were(25312.32±4960.79)yuan and in the nylon rope group were(27836.26±1974.21)yuan(t=-2.52,P<0.05).There was no significant difference in the time of open diet and the days of antibiotic use between the two groups(P>0.05).Conclusion The application of double clamp endoscope-assisted endoscopic full-thickness resection(EFR)for the treatment of gastric submucosal tumors originating from the intrinsic layer and below is a safe,practical,minimally invasive,cost-effective,and effective method,which is worthy of clinical promotion.
作者
邱凤娇
袁文杰
王春芽
董秀红
庄晓惠
李蕾
张红梅
QIU Fengjiao;YUAN Wenjie;WANG Chunya;DONG Xiuhong;ZHUANG Xiaohui;LI Lei;ZHANG Hongmei(Department of Gastroenterology,the Affliated Hospital of Weifang Medical University,Weifang 261031,China)
出处
《潍坊医学院学报》
2023年第5期385-387,共3页
Acta Academiae Medicinae Weifang
关键词
双钳道胃镜
尼龙绳辅助金属夹
胃黏膜下肿瘤
内镜下全层切除术
Double-clamp gastroscopy
Nylon rope-assisted metal clip
Gastric submucosal tumors
Endoscopic total resection
