软式内镜外科技术在胸部疾病中的临床应用  

Clinical Application of Flexible Endoscopic Surgical Techniques in Thoracic Diseases

作　　者：王雯[1] 吴光勤[1] 王蓉[1] 李达周[1] 曾智聪[1] 陈炜生[2] 

机构地区：[1]福建医科大学福总临床医学院(南京军区福州总医院)消化内科,福州350025 [2]福建医科大学福总临床医学院(南京军区福州总医院)心胸外科,福州350025

出　　处：《福建医科大学学报》2014年第2期116-120,共5页Journal of Fujian Medical University

基　　金：福建省科技厅国际合作项目(2010I003);福建省社会发展重点基金资助项目(2011Y0044)

摘　　要：目的探讨软式内镜外科技术在胸部疾病中的临床应用价值。方法回顾性分析78例行软式内镜手术的患者临床资料,其中手汗症35例(均行超细胃镜下经脐胸交感神经切断术),食管疾病43例[26例行内镜黏膜切除术(EMR),9例行内镜黏膜下剥离术(ESD),4例行内镜经黏膜下隧道肿瘤切除术(STER),4例行内镜下食管括约肌切开术(POEM)],随访观察治疗效果及安全性。结果 78例患者均顺利完成软式内镜下胸部疾病手术,术后所有患者恢复良好,未见明显出血、穿孔等并发症。随访1年,所有食管黏膜下隆起性病变均未见病变残留或复发;所有贲门失弛缓症患者吞咽梗阻感消失,可正常进食;所有手汗症患者,手部多汗症状明显改善。结论软式内镜外科技术对胸部疾病有较好的治疗效果,且安全、有效、微创。Objective To investigate the clinical value of flexible endoscopic surgical techniques in thoracic diseases.Methods A retrospective analysis of 78 consecutive patients with chest diseases undergoing endoscopic surgery was conducted in Fuzhou General Hospital.Among those 78 patients,35 patients with primary palmar hyperhidrosis had transumbilical thoracic sympathectomy with ultrathin endoscope.The other 43 patients had esophageal disease,among which 26 patients underwent endoscopic mucosal resection（EMR）,9 underwent endoscopic submucosal dissection（ESD）,4 underwent submucosal tunnel endoscopic resection（STER）,4 underwent peroral endoscopic myotomy（POEM）.The therapeutic effect and safety was observed in the follow-up time.Results All the 78 patients successfully underwent thoracic surgeries under the flexible endoscopic.All of them recovered well without significant bleeding,perforation and other complications.In one year＇s follow-up,all esophageal submucosal protuberant lesions showed no residua or recurrence; the sense of swallowing obstruction disappeared among patients with achalasia,all of them can eat normally;the sweating symptom of hands was improved significantly among patients with palmar hyperhidrosis.Conclusions The flexible endoscopic surgical technique is a safe,effective and minimally invasive therapy method of thoracic diseases with a good therapeutic effect.

关 键 词：创伤和损伤 平滑肌瘤 食管疾病 出汗 汗腺疾病 胸部疾病 外科手术 微创性 胸腔镜检查 

分 类 号：R655[医药卫生—外科学]