外套管在食管第一狭窄处枣核内镜取出术中的应用价值  

Gastroscopy assisted with trocar sheath in removal of date pit at the first stenosis of esophagus

作　　者：刘月[1] 宁守斌[1] 朱鸣[1] 李静[1] 银新[1] 张静[1] 

机构地区：[1]空军总医院消化内科

出　　处：《解放军医学院学报》2017年第2期128-131,共4页Academic Journal of Chinese PLA Medical School

摘　　要：目的探讨外套管在辅助内镜取出食管第一狭窄处枣核的临床应用价值。方法回顾性分析本院2008年10月-2016年8月收治的枣核嵌入食管第一狭窄处的41例患者,分别接受经外套管辅助内镜取出术、普通内镜取出术及喉镜取出术,部分患者因一种方法取出失败而接受另一种方法。比较不同方法在手术成功率、并发症及治疗操作时间等方面的差异。结果 19例外套管辅助胃镜下枣核取出术(包括5例喉镜取出手术失败者),年龄33~83(65.13±13.06)岁,成功率100%;13例接受普通胃镜取出术,年龄45~83(60.62±11.02)岁,成功率76.9%(10/13),3例未能取出,转由喉镜取出(3例均发生术后穿孔);17例接受喉镜取出术(包括3例普通内镜取出手术失败者),年龄45~79(65.18±9.89)岁,成功率70.6%(12/17),发生术后穿孔5例,5例未能取出者经外套管辅助内镜取出。平均操作时间:外套管组(4.35±0.66)min,低于普通胃镜组(8.47±0.92)min,喉镜组(5.85±0.47)min(P<0.05);视野暴露良好率:外套管组100%,高于普通胃镜组69.2%,喉镜组58.8%(P均<0.05);手术耐受性:外套管组89.5%,高于普通胃镜组76.9%,喉镜组52.9%(P均<0.05)。结论应用自制外套管辅助胃镜取出嵌入食管第一狭窄处枣核较传统方法更为安全有效,可提供良好视野,明显缩短操作时间。Objective To assess the value of trocar sheath in endoscopic removal of date pit at the first narrowing of esophageal.Methods Medical records of 41 patients admitted to our center for endoscopic removal of date pit at the first narrowing of esophageal from October 2008 to August 2016 were retrospectively collected and analyzed.Three options could be chosen to deal with date pit：gastroscopy assisted by trocar sheath, gastroscopy alone, and laryngeal endoscope.Average operating time of removing procedure, success rate, incidence of complications in 3 groups were compared.Results Nineteen cases were treated by gastroscopy assisted by trocar sheath with average age of（65.10 ±13.06） years（Among them, 5 cases underwent laryngeal endoscope procedures at first and failed to remove the pit）,and the success rate was 100%.Thirteen cases were treated with gastroscopy alone with average age of（60.62±11.02） years,and the success rate was 76.9%（10/13）.Three cases converted to laryngeal endoscope after failed gastrocopic removal and all of them complicated with perforation.Seventeen cases were treated with laryngeal endoscope with average age of（65.18±9.89）years, including 3 cases with unsuccessful gastroscopic removal.The success rate for laryngeal endoscopy group was 76.9%（12/17）.Five cases accepted gastroscopy procedure assisted with trocar sheath after failed laryngendoscope removal.Mean time of retrieve procedure was 4.35±0.66 min in trocar sheath assisted gastroscopy group, which was significantly less than 8.47±0.92 min in gastroscopy group and 5.85±0.47 min in laryngeal endoscopy group（P〈0.05, respectively）.Accuracy rates was 100% in trocar sheath assisted gastroscopy group, which was significantly higher 58.8% in gastroscopy group and 58.8% in laryngeal endoscope group（P〈0.05, respectively）.Acceptance rates was 89.5% in trocar sheath assisted gastroscopy group, which was significantly higher 76.9% in gastroscopy group and 52.9% for laryngeal endoscope group（P〈0.05, respect

关 键 词：外套管 食管 枣核 异物 内镜 

分 类 号：R768.3[医药卫生—耳鼻咽喉科]