对经口牵引辅助内镜黏膜下剥离术中牵引线制作方法的改良

Improvement of traction wire production method for traction ESD assisted by oral traction

摘要:

目的 介绍在经口牵引辅助下内镜黏膜下剥离术（ESD）中对牵引线制作的改良方案。方法 回顾性分析该院内镜中心40例患者中，通过使用改良牵引（实验组）和常规牵引（对照组）在治疗消化道早癌及癌前病变的临床资料的对比，比较两组性别、年龄、牵引线安装完善时间、固定病灶后止血夹脱落次数、一次性完整切除率、整块切除率、出血及穿孔等并发症的临床情况。结果 实验组牵引线安装完善时间（53.30±12.85）s明显短于对照组的时间（105.00±11.68）s（t =3.42，P <0.05）。实验组固定病灶后止血夹脱落次数明显少于对照组（χ2=2.37，P <0.05）。实验组一次性完整切除率（18/20，90%），对照组一次性完整切除率（17/20，85%）。两组整块切除率均为100%。两组均无出现大出血和穿孔等并发症。结论 运用创新性方法、充分的术前准备、术中操作者默契的护理配合、术后密切关注病情是达到内镜下理想治疗效果的关键。

Abstract:

Objective To introduce improved program for traction wire production in endoscopic submucosal dissection assisted by oral traction. Methods A retrospective analysis was performed on 40 patients who received endoscopy intervention. Through the use of improved traction and normal traction, they were divided into experimental group and control group. Then analyze and compare their clinical data like gender, age, traction line installed perfect time, fixed lesions after hemostatic clip off times, one-time complete resection, enbloc resection rate, bleeding and perforation and other complications and other clinical conditions. Results The improvement time was (53.30 ± 12.85) s in experimental group, it was significantly shorter than that in control group (105.00 ± 11.68) s (t = 3.42, P < 0.05). The experimental group fixed lesions after hemostatic clamp off times were significantly less than that in control group (χ2 = 2.37, P < 0.05). Conclusions Using innovative methods, adequate preoperative preparation, the operator's tacit understanding of nursing cooperation, close attention to the disease after surgery is the key to achieve the desired results of endoscopic surgery.