黏膜下注射生理盐水在食管、胃、结肠无蒂息肉内镜治疗中的应用

Application of submucosal injection of normal saline in therapeutic endoscope of the esophagus,stomach and colon sessile polyps

目的探讨黏膜下注射生理盐水与肾上腺素生理盐水,在食管、胃、结肠无蒂息肉内镜治疗中的疗效和安全性方面的差异。方法在内镜下治疗食管、胃、结肠无蒂息肉时,采用随机对照设计,设试验组和对照组,分别使用生理盐水和肾上腺素生理盐水(1∶10 000)进行黏膜下注射,随后用高频电刀切除病灶,在疗效和并发症方面进行对比研究。结果黏膜下注射生理盐水和肾上腺素生理盐水都可以有效地减少创面出血,且治疗效果确切,试验组和对照组无出血率分别为89.39%和92.31%,组间比较差异无统计学意义(P>0.05),对照组黏膜下注射后有8例心率增快、5例血压升高,两组比较差异有统计学意义(P<0.05)。结论在食管、胃、结肠无蒂息肉的内镜治疗中单纯使用生理盐水作为黏膜下注射液,既能有效预防穿孔,又能减少出血,尚可避免肾上腺素的并发症,可以取代肾上腺素生理盐水。

Objective To investigate the differences of curative effect and safety of submucosal injection of normal saline and adrenaline saline solution in therapeutic endoscope of the esophagus,stomach and colon sessile polyps.Methods Patients with esophagus,stomach amd colon sessile polyps were divided into experimental group and control group randomly,under endoscope,normal saline and adrenaline combined with normal saline（1∶10 000） was injected submucosal respectively,then polyps was resected by high frequency electrocautery.Therapeutic effect and complications were compared. Results Two injections were both effective on reducing bleeding in treating sessile polyps under endoscope.The rate of without bleeding of the experimental group and control group were 89.39% and 92.31% respectively,and had no statistical difference（P〉0.05）.After submucosal injection of the control group,8 patients with faster heart rate,blood pressure in 5 cases,the two groups were statistically different（P〈0.05）.Conclusion Normal saline submucosal injected in esophagus,stomach and colon sessile polyps under therapeutic endoscope can prevent perforation effectively and reduce bleeding and avoid the complications of epinephrine.Normal saline can be a substitution of epinephrine saline solution.