胃镜反转下接触式氩离子凝固术在膈下贲门部息肉治疗中的作用  

作　　者：杨春[1] 王盛根[1] 

机构地区：[1]东南大学医学院附属南京同仁医院消化内科,江苏南京211102

出　　处：《现代消化及介入诊疗》2018年第A02期167-168,共2页Modern Interventional Diagnosis and Treatment in Gastroenterology

摘　　要：目的:观察胃镜U形反转下接触式应用氩离子凝固术(APC)对膈下贲门部息肉进行治疗的可行性及其对胃镜镜身潜在烧灼的预防作用。方法:对31例膈下贲门部有小于1cm、基底较宽或扁平息肉(共34枚)的患者采用胃镜U形反转法接触式应用APC进行治疗。观察探头接触和治疗靶息肉的成功率、探头与凝固组织粘连的发生率,黏膜下气肿和穿孔的发生率,以及胃镜镜身灼伤的发生率。结果:30例(96.77%)患者行胃镜U形反转法探头成功接触到靶息肉(共33枚)。这些患者的息肉均在1次胃镜下行APC成功灼除。术中APC探头与凝固组织无明显粘连,未发生黏膜下气肿和穿孔。无一例发生胃镜镜身灼伤。结论:胃镜U形反转下接触式应用APC治疗膈下贲门部息肉的方法,安全有效,能预防氩气刀对胃镜镜身潜在的损伤。AIM:To observe the clinical values of applying contact-mode argon plasma coagulation(APC)for retroflex gastroscopic treatment of polyps located at subphrenic cardiac pars.METHODS:34 wide outsole and applanate polyps smaller than 1.0 cm located at subphrenic cardiac pars in 31 cases of patients were treated by contact-mode APC under U-type retroflex gastroscopy.The contacting rate of APC probe with polyps,success rate of curing polyps,rate of sticking between the probe and ablated tissue,incidence of submucosal emphysemas and perforation,and incidence of thermal injury to the gastroscope were observed.Results:Under U-type retroflex gastroscopy,the probe could contact successfully with 33 polyps in 30(96.77%)cases of patients.All polyps of these patients were completely ablated by APC in the first time of gastroscopic treatment.During the ablation,no obvious sticking between the probe and ablated tissue,without submucosal emphysemas or perforation occurred,and without thermal injury to the gastroscope body happened among all patients.Conclusion:Applying contact-mode APC for retroflex gastroscopic treatment of polyps located at the subphrenic cardiac pars is a safe and efficacious method,can preventing thermal injury to the gastroscope from the argon knife.

关 键 词：胃镜反转 接触式 氩离子凝固术 膈下贲门部 息肉 镜身热损伤 

分 类 号：R573.2[医药卫生—消化系统]