自制多功能器械附件支架在内镜黏膜剥离术中的应用研究  

Application of self-made multifunctional accessory stent in endoscopic mucosal dissection

作　　者：莫春荣 贺学强 钟生爱 李华俊 胡郁 覃露 卢水焕 王林 熊红 周水英 Mo Chunrong;He Xueqiang;Zhong Shengai;Li Huajun;Hu Yu;Qin Lu;Lu Shuihuan;Wang Lin;Xiong Hong;Zhou Shuiying(Department of Gastroenterology,924th Hospital of Joint Logistic Support Force of Chinese People′s Liberation Army,Guilin 541002,China;Nursing Department,924th Hospital of Joint Logistic Support Force of Chinese People′s Liberation Army,Guilin 541002,China;Department of Military Casualty Management,924th Hospital of Joint Logistic Support Force of Chinese People′s Liberation Army,Guilin 541002,China)

机构地区：[1]中国人民解放军联勤保障部队第九二四医院消化内科,桂林541002 [2]中国人民解放军联勤保障部队第九二四医院护理部,桂林541002 [3]中国人民解放军联勤保障部队第九二四医院军队伤病员管理科,桂林541002

出　　处：《中国实用护理杂志》2022年第1期45-49,共5页Chinese Journal of Practical Nursing

基　　金：广西壮族自治区卫生健康委员会自筹经费科研课题(Z20201301)。

摘　　要：目的探讨自制多功能内镜器械附件支架在内镜黏膜剥离(ESD)术中使用的安全性和效果。方法选取中国人民解放军联勤保障部队第九二四医院2019年5月至2021年2月接受ESD术的80例患者为研究对象。采用随机数字表法分为对照组和试验组各40例, 试验组使用自制内镜附件支架, 对照组不使用自制内镜附件支架。分析比较2组在手术体位、操作医生和护士完全相同的情况下, 手术时长、误拿取器械次数、术中器械污染次数、术后3~7 d感染情况。结果试验组误拿取器械出错率、术中器械污染率、术后3~7 d感染率分别为0.9%(8/856)、1.4%(12/856)、2.5%(1/40), 对照组分别为10.8%(96/887)、11.8%(105/887)、15%(6/40), 差异有统计学意义(χ^(2)=75.92、75.76、3.91, 均P<0.05);试验组手术时长为(51.56 ± 2.32) min, 对照组为(79.02 ± 2.83) min, 差异有统计学意义(t=-8.72, P<0.05)。结论患者实施ESD术时, 使用自制多功能器械附件支架用于放置所需的器械附件, 手术耗时短, 误拿取器械比率、术中器械污染比率、术后3~7 d感染率均下降, 提升了内镜微创手术的质量。Objective To investigate the safety and efficacy of self-made multifunctional endoscopic instrument accessory stent in endoscopic mucosal dissection(ESD).Methods A total of 80 patients who received ESD in 924th Hospital of Joint Logistic Support Force of Chinese People′s Liberation Army from May 2019 to February 2021 were selected as research object.Random number table method was used to divide patients into control group and experimental group,40 cases in each group.The experimental group used self-made endoscopic instrument accessory stent,and the control group did not use self-made endoscopic instrument accessory stent.The length of operation,the number of instruments taken by mistake,the number of instruments polluted during operation and the infection of postoperative 3-7 days under the same operation position,operating doctors and nurses were analyzed and compared between the two groups.Results The incidence of instruments taken by mistake,the incidence of instruments polluted during operation and the infection rate of postoperative 3-7 days were 0.9%(8/856),1.4%(12/856)and 2.5%(1/40)in the experimental group,which in the control group were 10.8%(96/887),11.8%(105/887)and 15.0%(6/40)respectively,there were significant differences between the two groups(χ^(2)=75.92,75.76,3.91,all P<0.05).The length of operation in the experimental group was(51.56±2.32)min,and that in the control group was(79.02±2.83)min,the difference was statistically significant(t=-8.72,P<0.05).Conclusions When the patients underwent ESD surgery,the self-made multifunctional accessory stent was used to place the required instrument accessory.The length of operation was shorter,the incidence of instruments taken by mistake,the incidence of instruments polluted during operation and the infection rate of postoperative 3-7 days were reduced,the quality of minimally invasive endoscopic surgery was improved.

关 键 词：自制内镜器械附件支架 内窥镜 内镜黏膜剥离术 护理 

分 类 号：R735[医药卫生—肿瘤]