上海交通大学学报（医学版）

上海交通大学学报（医学版） ›› 2017, Vol. 37 ›› Issue (7): 1010-.doi: ]10.3969/j.issn.1674-8115.2017.07.022?

• 论著（临床研究） • 上一篇    下一篇

橡皮圈牵引与牙线牵引辅助内镜黏膜下剥离术治疗消化道肿瘤 的临床对比研究

陈相波，许婷婷，吴秋丽，郑清凤   

  1. 福建医科大学附属泉州第一医院内窥镜室，泉州 362000
  • 出版日期:2017-07-28 发布日期:2017-08-25
  • 作者简介:陈相波（1973—），男，副主任医师，硕士生；电子信箱：colobo@sina.com

A clinical comparative study of rubber ring versus dental floss combined with hemoclipping assisted endoscopic submucosal dissection on gastrointestinal tumor#br#

CHEN Xiang-bo, XU Ting-ting, WU Qiu-li, ZHENG Qing-feng   

  1. Department of Gastrointestinal Endoscopy, Quanzhou First Hospital, Fujian Medical University,  Quanzhou 362000, China
  • Online:2017-07-28 Published:2017-08-25

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摘要：  目的 · 比较橡皮圈牵引与牙线牵引辅助内镜黏膜下剥离术（ESD）治疗消化道肿瘤的效果。方法 · 以橡皮圈牵引辅助 ESD 治 疗消化道肿瘤的 27 例患者为试验组，牙线牵引辅助ESD 治疗的患者 27 例为牙线组，观察相关指标，比较2 组手术时间、牵引装置 安装时间、止血夹脱离次数、黏膜损伤情况、一次性完整切除率、并发症及随访情况。结果 · 橡皮圈组止血夹脱离次数（2 次）明显 短于牙线组止血夹脱离次数（8 次），差异具有统计学意义（t=4.418，P<0.05）；橡皮圈组未发生装置引起的口咽部黏膜损伤，牙线组 口咽部黏膜损伤 3 例（11.1%）； 2 组一次性完整切除率均为 100%；2 组手术时间、牵引装置安装时间、并发症发生率比较，差异无统 计学意义（P>0.05）； 2 ～ 12 个月的随访后，橡皮圈组患者创面愈合良好，均无肿瘤局部复发。结论 · 橡皮圈牵引辅助 ESD 与牙线牵 引辅助 ESD 相比，装置不易脱离，尤其适合右半结肠的牵引辅助治疗，不易损伤组织黏膜，牵引方向可调节，是一种方便和有效的 辅助装置。

关键词: &ensp, 橡皮圈, 止血夹, 牙线, 牵引, 内镜黏膜下剥离术, 消化道肿瘤

Abstract:

Objective · To investigate and compare the curative effect of rubber ring and dental floss combined with hemoclipping assisted endoscopic submucosal dissection(ESD) on gastrointestinal tumors.  Methods · A total of 54 patients with gastrointestinal tumors were collected. Twenty-seven patients in rubber ring group accepted ESD assisted by rubber ring with hemoclipping, and the other 27 patients in dental floss group accepted ESD assisted by dental floss with hemoclipping. Duration of the operation, installation time of the traction device, detachment frequency of hemoclipping, injury of mucosa, one-time complete resection rate, and complication rate were analyzed as key indicators.  Results · The detachment frequency of hemoclipping in rubber ring group was significantly less than that in dental floss group (t=4.418, P<0.05). There was no injury of mucosa in rubber ring group, while, three patients had mucosa injury in dental floss group. There was no statistically significant difference on duration of operation, installation time of traction device, one-time complete resection rate, and complication rate between two groups. After 2 ～ 12 months of follow-up, the wound healed well in all patients in rubber ring group. No evidence of tumor recurrence was noted.  Conclusion · Compared with dental floss, rubber ring combined with hemoclipping is superior in assisted ESD, especially in the right half colon. It is an effective assist device with little trauma and adjustable direction.

Key words: rubber ring, hemoclipping, dental floss, traction, endoscopic submucosal dissection, gastrointestinal tumour