预荷包缝合技术在腔外生长型胃黏膜下肿瘤内镜治疗中的应用  

Therapeutic effect of the pre-purse-string suture on gastric lesions of external growth under endoscopy

作　　者：李歆[1] 肖勇[1] 吴楠楠[1] 曾西[1] 王芳[1] 刘仕倩 于红刚[1] 陈明锴[1] 

机构地区：[1]武汉大学人民医院消化内科 武汉大学人民医院消化内镜中心 湖北省消化疾病微创诊治医学临床研究中心,武汉430060

出　　处：《中华消化内镜杂志》2017年第8期586-589,共4页Chinese Journal of Digestive Endoscopy

摘　　要：目的探讨金属夹和尼龙绳联合行内镜下“预荷包缝合”技术在腔外生长型胃黏膜下肿瘤内镜治疗中的临床疗效。方法2016年8月至10月在武汉大学人民医院消化内镜中心27例腔外生长型胃黏膜下肿瘤行内镜黏膜下剥离术（ESD）的患者，按随机分组原则根据病灶在ESD中未穿孔之前是否行预荷包缝合修补治疗分为两组，一组为“预荷包缝合”技术完成（研究组），一组为常规ESD剥离病灶穿孔后行“荷包缝合”（对照组），比较两组的病变平均大小、手术时间、拔除胃肠减压管时间、住院时间。结果研究组的15例患者中，胃窦3例，胃体6例和胃底6例；对照组的12例患者中，胃窦大弯侧2例、胃窦后壁1例、胃体大弯侧4例，胃体前壁1例及胃底4例。所有患者均顺利完成内镜下手术，术后无明显并发症发生。研究组和对照组的病变平均大小为2．5cm×3．2cm和2．4cm×3．0cm（P=0．63），研究组的手术时间为28．0-43．0min[（35．8±6．1）min]；对照组的手术时间为45．6～68．8min[（48．8±5．3）min]，两组比较差异有统计学意义（P〈0．01）。结论金属夹和尼龙绳联合行内镜下“预荷包缝合”技术在腔外生长型胃黏膜下肿瘤内镜治疗中的临床疗效良好。Objective To investigate the clinical effect of ＂pre-purse-string＂ suture on submucous gastric lesions of external growth type in endoscopic patients. Methods Clinical data of 27 patients with gastric lesions of external growth type admitted to the digestive endoscopy center of Renmin Hospital of Wuhan University from August 2016 to October 2016 for endoscopic submucosal dissection （ESD） were analyzed. Patients were randomly divided into two groups, the experiment group receiving the ＂ pre-purse- string＂ suture, the control group receiving purse-string suture after ESD. Mean size of the lesions, procedure time, withdrawal time of gastric decompression, and hospitalization time were compared. Results In the 15 patients of the experiment group, there were 3 cases whose lesions were located in gastric antrum, 6 in gastric body and 6 in gastric fundus. In the 12 cases of the control group, 3 lesions were located in gastric antrum, 5 in gastric body and 4 in gastric fundus. All procedures were successfully completed in endoscopy. No obvious postoperative complications occurred. The mean size of lesions was 2. 5 cm× 3.2 cm in the experiment group, and 2. 4 cm × 3.0 cm in the control group （ P = 0. 63 ）. The operation time was 28.0- 43.0 min （35.8±6. 1 min） in the experiment group, and 45.6-68.8 min （48.8±5.3 min） in control group （P〈0. 01）. Conclusion ＂ Pre-purse-string＂ technique is of clinical effect on gastric submucosal tumor of external growth.

关 键 词：胃肿瘤 内镜黏膜下剥离术 荷包缝合 

分 类 号：R735.2[医药卫生—肿瘤]