透明质酸钠、甘油果糖混合液黏膜下注射行内镜黏膜下剥离术:26例临床分析  

Mixture of Sodium Hyaluronate,Glycerin and Fructose Used for Submucosal Injection in Endoscopic Submucosal Dissection:Clinical Analysis of 26 Cases

作　　者：高雪峰[1] 丁岩冰[1] 邓彬[1] 吴健[1] 肖炜明[1] 陈海燕[1] 张献梅[1] 

机构地区：[1]扬州市第一人民医院消化内科

出　　处：《胃肠病学》2010年第5期299-301,共3页Chinese Journal of Gastroenterology

摘　　要：背景：内镜黏膜下剥离术（ESD）逐渐成为消化道早期癌症和癌前病变的首选治疗手段,但目前对术中选择何种黏膜下注射液尚未达成共识.目的：评估ESD术中黏膜下注射透明质酸钠、甘油果糖混合液的临床价值.方法：纳入2007年12月～2009年8月扬州市第一人民医院收治的26例经染色内镜和内镜超声检查诊断为消化道黏膜及黏膜下病变的患者,黏膜下注射透明质酸钠、甘油果糖混合液行ESD治疗,分析操作一般情况、剥离成功率以及穿孔发生率.结果：本组患者切除标本最大长径1.3～4.3 cm,平均2.6 cm;ESD操作时间28～162 min,平均62.6 min;平均黏膜下注射量为26.6 ml.剥离成功率92.3%.1例食管平滑肌瘤术后出现纵隔气肿,经保守治疗后痊愈.穿孔发生率3.8%.ESD术后患者平均住院时间为4.2 d,平均随访4.5个月,复查内镜示创面基本愈合,无复发.结论：黏膜下注射透明质酸钠、甘油果糖混合液行ESD的疗效良好,安全性高.Background： Endoscopic submucosal dissection （ESD） has become the preferred therapeutic modality for early cancer and precancerous lesion of digestive tract, but the consensus on material used for submucosal injection in ESD has not yet reached. Aims： To assess the clinical value of mixture of sodium hyaluronate, glycerin and fructose for submucosal injection in ESD. Methods： Twenty-six patients diagnosed as having digestive tract mucosal and submueosal lesions by chromoendoscopy and endoscopic ultrasonography, were treated with mixture of sodium hyaluronate, glycerin and fructose for submucosal injection in ESD from December 2007 to August 2009 at Yangzhou First People＇s Hospital. General aspects of the procedure, success rate and perforation rate were analyzed. Results： The longitudinal diameter of lesion was 1.3-4.3 cm with a mean of 2.6 cm, duration of the procedure was 28-162 minutes with a mean of 62.6 minutes, and the average dosage of submueosal injection was 26.6 ml. Success rate of dissection was 92.3%. Mediastinal emphysema occurred in 1 case of esophageal leiomyoma during dissection, but recovered after conservative treatment, the perforation rate was 3.8%. The mean hospital stay after ESD was 4.2 days, the mean follow-up duration was 4.5 months. Surface wound was healed without recurrence under endoscopy. Conclusions： The use of mixture of sodium hyaluronate, glycerin and fructose for submucosal injection in ESD is safe and with excellent results.

关 键 词：内镜黏膜下剥离术 透明质酸 甘油 果糖 治疗 

分 类 号：R735[医药卫生—肿瘤]