采用圈套器行内镜下切除术在胃黏膜下肿物治疗中的临床应用效果  

Clinical application of endoscopic resection using snares in treatment of gastric submucosal tumors

作　　者：卢曼曼 李贞娟 徐闪闪 张慧敏 王雪雁 李佳鑫 全润钊 张昊 丁辉 李修岭 Lu Manman;Li Zhenjuan;Xu Shanshan;Zhang Huimin;Wang Xueyan;Li Jiaxin;Quan Runzhao;Zhang Hao;Ding Hui;Li Xiuling(Department of Gastroenterology,People’s Hospital of Zhengzhou University(Henan Provincial People’s Hospital),Zhengzhou,Henan 450003,China)

机构地区：[1]郑州大学人民医院(河南省人民医院)消化内科,河南郑州450003

出　　处：《中国内镜杂志》2024年第11期39-46,共8页China Journal of Endoscopy

摘　　要：目的探讨采用圈套器行内镜下切除术治疗胃黏膜下肿物(SMTs)的安全性和有效性。方法回顾性分析2017年8月-2023年8月该院行内镜下切除治疗的66例胃SMTs患者的临床资料,根据所用手术器械不同,分为:圈套器组(采用圈套器行内镜下切除,n=33)和传统切除组(采用传统一次性黏膜切开刀行内镜下切除,n=33)。比较两组患者手术时间、整体切除率、不良反应发生率、手术费用、住院费用和术后住院时间等。结果圈套器组病变直径为8.00(6.00,14.00)mm,传统切除组病变直径为8.00(7.50,10.00)mm,两组患者比较,差异无统计学意义(P>0.05);圈套器组手术时间为26.00(19.00,30.50)min,明显短于传统切除组的33.00(22.50,49.50)min,差异有统计学意义(P<0.05);两组患者整体切除率均为100.0%;两组患者均未发生术中穿孔,两组患者术中出血、腹痛和发热等不良反应发生率比较,差异均无统计学意义(P>0.05);圈套器组手术费用为(8642.18±1078.56)元,明显少于传统切除组的(13266.45±2160.80)元,差异有统计学意义(P<0.05);结论与传统操作器械相比,采用圈套器行内镜下切除术治疗胃SMTs,操作时间更短、手术费用更低,且安全有效,值得临床推广。Objective To investigate the clinical efficacy and safety of endoscopic resection using snares for the treatment of gastric submucosal tumors(SMTs).Methods 66 patients diagnosed with gastric SMTs and treated with endoscopic resection from August 2017 to August 2023 were retrospectively analyzed and divided into the snare group(endoscopic resection using snares,n=33)and the traditional resection group(endoscopic resection using a traditional disposable incision knife,n=33).The operation time,overall resection rate,incidence of adverse reactions,operation cost,hospitalisation cost,and the post-operative hospital days were compared between the two groups.Results The lesion diameter was 8.00(6.00,14.00)mm in the snare group and 8.00(7.50,10.00)mm in the traditional resection group,the difference between the two groups was not statistically significant(P>0.05);The operative time in the snare group was significantly shorter than that in the traditional resection group[26.00(19.00,30.50)min vs 33.00(22.50,49.50)min],the difference was statistically significant(P<0.05);The overall resection rate in both groups was 100.0%;Neither group of patients had intraoperative perforation.There were no statistically significant differences in the incidence of adverse reactions such as intraoperative bleeding,abdominal pain and fever between the two group(P>0.05);The operative cost of the snare group was significantly lower than the traditional endoscopic resection group[(8642.18±1078.56)yuan vs(13266.45±2160.80)yuan],the difference was statistically significant(P<0.05).Conclusion Compared with traditional surgical instruments,endoscopic resection of gastric SMTs using snares has a shorter operating time,lower surgical costs,safe and effective,making it worthy of promotion.

关 键 词：黏膜下肿物(SMTs) 内镜全层切除术(EFR) 内镜黏膜下剥离术(ESD) 圈套器 一次性黏膜切开刀 不良反应 

分 类 号：R735.2[医药卫生—肿瘤]