止血绫修复内镜黏膜下剥离术后创面的应用研究*

Application of hemostatic silk shielding on ulcers induced by endoscopic submucosal dissection*

摘要:

目的??探讨止血绫在内镜黏膜下剥离术（ESD）后预防创面出血及创面修复中的临床应用价值。方法?采用活体兔对比研究手术切开兔胃后的出血量（ml），并以活体猪为研究对象行结肠ESD手术，实验组术后用止血绫进行覆盖，对照组创面则不予以处理，术后3天、1周、2周及4周分别进行内镜及病理学检查，比较两组的创面出血及组织愈合情况。结果?兔胃出血量对比实验中，实验组出血量明显低于对照组，实验猪行结肠ESD术后创面均成功覆盖止血绫。行内镜检查及病理检查，实验组存在修复优势。实验组与对照组总共24处创面中，均未出现感染、穿孔等实验相关的不良事件。结论?止血绫在临床ESD后创面修复中具有潜在的应用价值。

Abstract:

Objective?To investigate the clinical value of hemostatic silk in prevention of wound bleeding and wound healing after endoscopic submucosal dissection (ESD).?Methods?Experiment group: animal model was made by rabbit underwent ESD simulation in its’ stomach and laying hemostatic silk on its’ wound; control group: animal model was made by pig underwent ESD simulation in its’ colon without any healing management. All the ulcers sites were endoscopically and pathologically examined to evaluate the hemorrhage and healing of the wound on 3 days, 1 week, 2 weeks and 4 weeks after the procedure.?Results?The blood loss in experiment group was significantly lower than that in control group. The wounds of all the experimental pigs underwent colon ESD successfully covered with hemostatic silk postoperatively. Endoscopic pathological examination shown better healing procedure in experiment group. No procedure-related adverse event occurred in both groups.?Conclusions?Hemostatic silk has potential application value in healing the wound after ESD demonstrated by animal experiment.