橡皮圈联合金属夹的内牵引技术在内镜黏膜下剥离术中的临床应用  

Clinical application of internal traction technology using rubber bands combined with metal clips in endoscopic submucosal dissection

作　　者：刘雪[1] 张静智[1] 曾玲[1] LIU Xue;ZHANG Jingzhi;ZENG Ling(Department of Gastroenterology,Ganzhou People's Hospital,Jiangxi Province,Ganzhou341000,China)

机构地区：[1]江西省赣州市人民医院消化内科,江西赣州341000

出　　处：《中国当代医药》2024年第2期37-40,共4页China Modern Medicine

基　　金：江西省卫生健康委科技计划项目(202120025);江西省赣州市科技计划项目(20222ZDX7578)。

摘　　要：目的分析橡皮圈联合金属夹的内牵引技术在内镜黏膜下剥离术(ESD)中的应用效果。方法选取2022年1月至12月赣州市人民医院收治的行ESD治疗的60例患者为研究对象,采用随机数字表法将其分为对照组与观察组,各30例。对照组采用传统ESD治疗,观察组采用橡皮圈联合金属夹的内牵引技术辅助ESD治疗。比较两组的手术情况、并发症、随访情况。结果两组的病灶面积、一次性完整切除病变率、并发症发生率及复发率比较,差异无统计学意义(P>0.05)。观察组单位时间切除率高于对照组,黏膜暴露到完整剥离时间、手术时间、住院时间短于对照组,差异有统计学意义(P<0.05);随访3个月,两组均无原发病灶残留,内镜复查显示手术创面均愈合良好;均未出现复发。结论橡皮圈联合金属夹的内牵引技术在ESD中作用明显,可充分暴露创面视野,有助于提高剥离精准度,缩短手术时间,能够减少ESD手术并发症及麻醉发生风险,促进恢复,临床应用价值较高,值得临床行大力地推广与应用。Objective To analyze the application effect of rubber band combined with metal clip internal traction technology in endoscopic submucosal dissection(ESD).Methods A total of 60 patients who were treated with ESD in Ganzhou People's Hospital from January 2022 to December 2022 were selected as the research objects,and they were divided into control group and observation group by random number table method,with 30 cases in each group.The control group received traditional ESD treatment,while the observation group received internal traction technology with rubber bands and metal clips to assist with ESD treatment.The surgical situation,complications,and follow-up were compared between the two groups.Results There were no statistically significant differences between the two groups in terms of lesion area,rate of complete resection,incidence of complications and recurrence rate(P>0.05).The resection rate per unit time in the observation group was higher than that in the control group,and the time from mucosal exposure to complete dissection,surgical time,and hospitalization time were shorter than those in the control group,with statistically significant differences(P<0.05).Follow up for 3 months showed no residual primary lesions in both groups,and endoscopic examination showed that the surgical wounds healed well.No recurrence occurred.Conclusion The internal traction technology of rubber band combined with metal clip has a significant effect on ESD,which can fully expose the wound field of view,improve the accuracy of dissection,shorten the surgical time,reduce the complications and anesthesia risks of ESD surgery,promote recovery,and have high clinical application value.It is worth promoting and applying in clinical practice.

关 键 词：内镜黏膜下剥离术 橡皮圈 金属夹 内牵引技术 并发症 复发 

分 类 号：R615[医药卫生—外科学]