口服碳酸氢钠不同时间对内镜碎石法治疗巨大胃石疗效的影响  

Curative effect of sodium bicarbonate on huge bezoars with endoscopic mechanical lithotripsy

作　　者：谯秋建[1] 于劲[1] 李先来[1] 宋元鲲[1] 柏健鹰[1] 

机构地区：[1]第三军医大学新桥医院消化内科,重庆400037

出　　处：《第三军医大学学报》2015年第14期1491-1493,共3页Journal of Third Military Medical University

摘　　要：目的探讨口服碳酸氢钠不同时间对内镜治疗巨大胃石疗效的影响。方法 2009年12月至2014年7月在本科内镜确诊的68例巨大胃石症患者,术前口服5%碳酸氢钠溶液125 m L,每天4次,根据服药时间分为未用药组和用药3、5、7 d组,每组17例。服药后复查胃镜,有胃石者采用内镜下碎石和取石,不能一次性碎石的,采用同样的方法服用碳酸氢钠1 d,再碎石和取石。结果未用药组和用药3、5、7 d组第1、2、3次胃镜碎石取出率分别为23.5%vs 47.1%vs 64.7%vs 94.1%,41.2%vs35.3%vs 29.4%vs 5.9%,35.3%vs 17.6%vs 5.9%vs 0。4组取出次数总体百分比经χ2检验差异具有统计学意义(χ2=20.640,P=0.002)。取石过程中68例患者均未出现出血、穿孔和肠梗阻等并发症。结论胃镜联合碳酸氢钠治疗巨大胃石安全可靠,尤其是服药7 d后取石,更能提高一次性成功率和效率,值得推广及应用。Objective To evaluate the curative effect of sodium bicarbonate on huge bezoars with endoscopic mechanical lithotripsy. Methods Sixty-eight patients with huge bezoars were detected with a gastroscope in our hospital from December 2009 to July 2014,and they orally took 5% sodium bicarbonate125 m L for 4 times per day. According to sodium bicarbonate taking time,the patients were randomly divided into drug-free group,3-day group,5-day group,and 7-day group. The bezoars were broken into pieces and removed out after gastroscopy. If the bezoars were not removed out at a time,5% sodium bicarbonate was administrated again in the same way. After that,the bezoars were broken into pieces and removed out until all the bezoars were removed out. Results The huge bezoar removal rates of the 4 groups were 23. 5%,47. 1%,64. 7%,and 94. 1%,respectively,on the first time,were 41. 2%,35. 3%,29. 4%,and 5. 9%,respectively,on the second time,and were 35. 3%,17. 6%,5. 9%,and 0,respectively,on the third time.There was no patient with bleeding,gastrointestinal perforation and intestinal obstruction. Conclusion Sodium bicarbonate combined with gastroscopy is safe and effective in removing huge bezoars and is worth of clinical application. Especially,after taking sodium bicarbonate for 7 d,one-time success rate and efficiency are improved.

关 键 词：巨大胃肠结石 胃镜 碳酸氢钠 

分 类 号：R573.8[医药卫生—消化系统] R975.2[医药卫生—内科学]