钩刀J在结肠病变内窥镜黏膜下剥离术治疗中的临床疗效及安全性研究  

Research on clinical efficacy and safety of Hook Knife J endoscopic submucosal dissection in colonic lesions

作　　者：舒磊[1] 杨林[1] 刘嵩[1] 刘怡[1] 时昭红[1] SHU Lei;YANG Lin;LIU Song(Department of Gastroenterology,Wuhan No.1 Hospital,Wuhan 430022,China;不详)

机构地区：[1]武汉市第一医院消化内科,湖北武汉430022

出　　处：《中国医学装备》2023年第7期36-40,共5页China Medical Equipment

基　　金：湖北省自然科学基金(2021CFB246)“附子抑制溃疡性结肠炎功效成分的筛选及其作用机制研究”。

摘　　要：目的:探讨钩刀J(hook knife J)在结肠病变内窥镜黏膜下剥离术(ESD)治疗中的临床疗效及安全性。方法:选取医院收治的40例结肠侧向发育型肿瘤或腔内突起型腺瘤患者,按照随机数表法将其分为对照组和观察组,每组20例,对照组采用普通钩刀(hook knife)进行ESD治疗,观察组采用改进后的钩刀J进行ESD治疗。对比分析两组ESD治疗的手术成功率、手术时间以及内窥镜器械交换及电凝钳使用频次。结果:两组患者ESD治疗成功率均为100%,对照组中出现肌层穿孔并发症1例(占5%)。观察组手术时间和器械交换频次分别为(50.50±11.82)min和(12.40±2.66)次,均低于对照组,两组比较差异有统计学意义(t=5.013,t=11.189;P<0.05);观察组电凝钳使用频次为2(2,1)次,低于对照组的4(3,5)次,其差异有统计学意义(H=-4.691,P<0.05)。结论:使用钩刀J进行ESD治疗,除保留原刀型特性外,其兼容的注水功能能够提升ESD治疗有效性及安全性,并可提高ESD治疗的成功率。Objective:To explore the clinical efficacy and safety of Hook knife J endoscopic submucosal dissection(ESD)in colonic lesions.Methods:A total of 40 patients with colonic laterally spreading tumors or intraluminal protruding adenoma admitted to the hospital were selected and divided into control group observation group according to random number table method,with 20 cases in each group.The control group received ESD treatment with ordinary crook knife,and the observation group was treated with improved hook knife J.The ESD operation success rate,operation time,frequency of endoscopic instrument exchange and use of electrocoagulation forceps were compared and analyzed between the two groups.Results:The success rate of endoscopic surgery in the two groups were 100%,complications of muscular perforation occurred in one case(accounting for 5%)in the control group.The operation time and instrument exchange frequency in the observation group were(50.50±11.82)minutes and(12.40±2.66)times,respectively,which were lower than those in the control group,and the difference was statistically significant(t=5.013,t=11.189,P<0.05).The frequency of use of electrocoagulation forceps in the observation group was 2[2,1]times,which was lower than that in the control group 4[3,5]times,and the difference was statistically significant(H=-4.691,P<0.05).Conclusion:Using hook knife J for ESD treatment,can not only retain the characteristics of the original knife,but also improve the efficacy and safety of ESD therapy with its compatible water injection function,and increase the success rate of ESD therapy.

关 键 词：内窥镜黏膜下剥离术(ESD) 钩刀(hook knife) 注水功能钩刀 结肠腺瘤 

分 类 号：R574.62[医药卫生—消化系统]