超细胃镜检查3844例临床分析  

Clinical analysis of ultrathin gastroscopy in 3,844 cases

作　　者：崔忠敏[1] 郭晓钟[1] 邵晓冬[1] 赵佳钧[1] 任丽楠[1] 吴春燕[1] 

机构地区：[1]沈阳军区总医院消化内科,110840

出　　处：《现代消化及介入诊疗》2012年第5期268-271,共4页Modern Interventional Diagnosis and Treatment in Gastroenterology

摘　　要：目的探讨超细胃镜检查的临床应用价值。方法 2004年5月至2012年5月间,应用FU-JINON公司生产的EG-470N5型上消化道超细电子胃镜(鼻胃镜)对3844例患者进行经鼻腔/口腔检查,其中常规内镜检查3786例,急诊内镜检查58例,并对72例患者进行了内镜下介入治疗及操作,包括止血、溶石术、息肉电切、异物取出、支架置入及放置螺旋型鼻肠管或辅助胶囊内镜检查。结果经鼻插镜3694例,经口150例,检出慢性胃炎2022例,消化性溃疡754例,食管炎310例,食管胃底静脉曲张、门脉高压性胃病184例,胃癌及残胃癌100例,Barrett食管64例,十二指肠球炎52例,上消化道息肉48例,残胃炎、吻合口溃疡及吻合口炎37例,食管癌29例等。因普通胃镜无法通过而经鼻胃镜检查明确诊断者16例,其中食管癌6例,胃癌4例,腐蚀性食管炎、贲门癌及球部溃疡并严重狭窄各2例。急诊内镜检查58例,54例明确诊断。镜下止血治疗29例,均获成功。活检594例次,诊断符合率94.2%。辅助螺旋型鼻肠管放置及胶囊内镜检查25例。溶石及息肉电切治疗各2例。10例因食管癌癌性狭窄患者均成功置入覆膜金属支架。成功取出嵌顿于食管的鱼刺4例。无消化道出血、穿孔等严重不良反应发生。结论超细胃镜检查痛苦小,患者易于接受,对常见上消化道疾病具有良好的诊断价值,通过超细胃镜尚可进行息肉电切、局部喷洒止血、支架置入及取出异物等内镜介入治疗,具有良好的临床应用前景。Objeetive To probe the clinical value of ultrathin gastroscopy.Methods From May 2004 to May 2012,3,844 consecutive patients were examined with ultrathin gastroscopy（type EG-470N5,FUJINON） either transnasally or transorally.During the procedures,interventional therapy including hemostasis,gastrolith lysis,polyp resection,foreign body removal and placement of esophageal stent,naso-enteric nutrition tube and capsule-endoscopy,was performed in 72 patients.Results Three thousand six hundred and ninety-four patients received the examination through nose and 150 via mouth.The detected disorders mainly included chronic gastritis（2,022 case）,peptic ulcer（754 cases）,esophagitis（310 cases）,esophageal varices and portal hypertensive gastropathy（184 cases）,gastric cancer（101 cases）,Barrett＇s esophagus（64 cases）,duodenagitis（52 cases）,upper gastrointestinal tract polyps（48 cases） and so on.Sixteen patients with severe stenosis were definitely diagnosed and 42 patients received emergency gastroscopy.Biopsy was conduced in 594 cases and the general diagnostic rate was 94.2%.Interventional therapy was successfully performed in 47 patients（29 eases of hemostasis,2 cases of gastrolith lysis,2 cases of polyp resection,4 cases of foreign body removal and 10 cases of esophageal stent placement）.In 25 cases,transnasal gastroscope was used as a tool to accomplish the placement of naso-enteric nutrition tube and capsule-endoscopy.No complications such as perforation and bleeding occurred.Conclusion Ultrathin gastroscopy has great practical value in the diagnosis and treatment of the upper digestive disorders.

关 键 词：超细胃镜 诊断 治疗 

分 类 号：R573[医药卫生—消化系统]