尼龙绳辅助金属夹在内镜治疗性胃穿孔中的应用

Application of endoloop plus metal clips in gastroscopic treatment of gastric perforation

摘要:

目的探讨尼龙绳辅助金属夹在内镜闭合治疗性胃穿孔中的临床应用价值。方法回顾性分析42例胃黏膜下肿瘤（SMT）行内镜下治疗术，术中发生穿孔的患者临床资料，并随机选择应用尼龙绳辅助金属夹闭合（尼龙绳组）与单纯金属钛夹闭合（单纯钛夹组），比较两组临床治疗效果。结果两组患者均顺利完成手术。两组闭合穿孔耗时比较差异无统计学意义（P >0.05）；在使用钛夹数量、留置胃管时间、术后开放饮食时间、抗生素应用时间、术后住院时间及住院总费用方面，尼龙绳组均少于单纯钛夹组，差异有统计学意义（P <0.05）。两组的术后并发症比较差异无统计学意义（P >0.05）。所有患者好转出院。术后3 个月复查胃镜，两组创面全部愈合。结论尼龙绳辅助金属夹可能有有更好的临床治疗效果。

Abstract:

Objective To investigate the therapeutic effect of endoloop combined with metal clips in the gastroscopic treatment of gastric perforation. Methods A total of 42 patients diagnosed with gastric submucosal tumor (GSMT) who received endoscopic treatment complicated gastric perforation were included retrospectively in this study. Patients were treated randomly with either of the following two ways: endoloop plus metal clips (endoloop group) or metal clips only (clip group). Results Endoscopic operation was successfully performed in both groups. No significant difference in time of procedure between two groups was observed (P > 0.05).Quantity of clips applied in the clip group was much more compared with the endoloop group. Time of duration for gastric tube intubation and fasting, application of antibiotics, postoperative hospital stay, and overall costing in endoloop group was significantly decreased compared with the clip group, respectively (P <0.05). There were no dramatic difference in postoperative complications between two the groups (P > 0.05). All patients were recovered with satisfactory healing of surgical wound after 3 months. Conclusions Application of endoloop combined with metal clips shows promising therapeutic effect in endoscopic treatment of gastric perforation.