平头注射针和锥形导管在结肠憩室粪石嵌顿水压松解治疗中的对比研究(含视频)  

A comparative study on flat-tipped injection needle and conical catheter in the treatment of hydrodynamic releasing of fecal calculus incarceration in the colonic diverticulum(with video)

作　　者：林燕娟 黄耀奎[1] 王小忠[1] Lin Yanjuan;Huang Yaokui;Wang Xiaozhong(Endoscope Center,Shantou Central Hospital,Shantou 515031,China)

机构地区：[1]汕头市中心医院内镜中心,汕头515031

出　　处：《中华消化杂志》2024年第4期245-249,共5页Chinese Journal of Digestion

摘　　要：目的探讨平头注射针和锥形导管两种器械样品在结肠憩室粪石嵌顿水压松解治疗中的有效性和安全性。方法前瞻性选择2022年5月1日至2023年7月31日在汕头市中心医院内镜中心接受结肠镜检查发现结肠憩室粪石嵌顿者77例。采用随机数字表法将77例患者随机分为平头注射针组(39例,粪石嵌顿51枚)和锥形导管组(38例,粪石嵌顿49枚)。观察两组患者的粪石松解成功率、手术时间和并发症情况。采用独立样本t检验和卡方检验进行统计学分析。结果平头注射针组粪石松解成功率高于锥形导管组[100.0%(51/51)比83.7%(41/49)],差异有统计学意义(χ^(2)=9.05,P=0.002)。平头注射针组与锥形导管组粪石松解成功病例的手术时间比较[(5.7±1.2)s比(5.9±0.8)s],差异无统计学意义(P>0.05)。两组患者在粪石松解过程中,均未出现术中及术后出血、穿孔;平头注射针组有4例患者出现黏膜下注射失误,锥形导管组有3例患者出现黏膜下注射失误,两组并发症发生情况比较,差异无统计学意义(P>0.05)。结论两种器械样品在结肠憩室粪石嵌顿水压松解治疗中都是有效和安全的,平头注射针的松解成功率高于锥形导管。Objective To explore the validity and safety of flat-tipped injection needle and conical catheter these 2 instruments in the hydrodynamic releasing treatment of fecal calculus incarceration in the colonic diverticulum.Methods From 1 May 2022 to 31 July 2023,77 patients with fecal calculus incarceration in colonic diverticulum detected by colonscopy at the Endoscope Center of Shantou Central Hospital were prospectively selected.According to the random number table method,77 patients were randomly divided into the flat-tipped injection needle group(39 cases,51 fecal stone embedded)and the conical catheter group(38 cases,49 fecal stone embedded).The successful rate of fecal stone releasing,operation time and complications of 2 groups were observed.Independent samples t test and chi-square test were used for statistical analysis.Results The successful rate of fecalith releasing of flat-tipped injection needle group was higher than that of the conical catheter group(100.0%,51/51 vs.83.7%,41/49),and the difference was statistically significant(χ^(2)=9.05,P=0.002).There was no significant difference in the operation time of successful cases between the flat-tipped injection needle group and the conical catheter group((5.7±1.2)s vs.(5.9±0.8)s,P>0.05).There were no cases of intraoperative or postoperative bleeding or perforation in the process of fecal stone releasing in both groups.Missed submucosal injection occurred in 4 cases of the flat-tipped injection needle group and occurred in three cases of the conical catheter group,and there was no significant difference in the incidence of complications between the 2 groups(P>0.05).Conclusion Both instruments are effective and safe in the hydrodynamic releasing treatment of fecal calculus incarceration in the colonic diverticulum,and the success rate of flat-tipped injection needle is higher than that of conical catheter.

关 键 词：内窥镜检查 胃肠道 结肠憩室粪石嵌顿 松解 平头注射针 锥形导管 疗效 

分 类 号：R574.62[医药卫生—消化系统]