植物性胃石经碳酸饮料治疗的临床分析

The research and analysis of gastric phytobezoars in the treatment of carbonated beverage

目的探讨胃石尤其是植物性胃石症的成因及其治疗方法。方法总结该院29例内镜确诊为植物性胃石症的患者,采用内镜联合碳酸饮料口服治疗,10例胃石小于5 cm×5 cm者行内镜下碎石及取石术,初次碎石、取石不成功及胃石大于5 cm×5 cm者均采用口服碳酸饮料2周、总剂量14 L的治疗方法 ,2周后复查胃镜评估治疗效果。结果 29例植物性胃石症患者中2例因合并有胃癌转外科手术,10例胃石小于5 cm×5cm行内镜下碎石及取石术者成功8例,失败的2例及胃石大于5 cm×5 cm的17例共计19例患者采用碳酸饮料口服治疗2周后有15例完全溶解,4例巨大结石明显变小软化,复查胃镜时予圈套器取出。结论我国植物性胃石症的成因与食用高鞣酸水果有关,超过5 cm×5 cm的巨大胃石建议采用碳酸饮料口服结合内镜下碎石、取石的策略,其患者依从性好,经济负担小,疗效显著,值得临床推广。

【Objective】 To investigate the pathogenesis and the treatment in gastric phytobezoars patients.【Methods】We selected 29 patients diagnosed as gastric phytobezoars pancreatitis to treat under endoscope combination with administration of carbonated beverage.Ten patients whose phytobezoar was less than 5 cm ×5 cm were treated by endoscope and two patients treatment were failed.Other patients were treated by carbonated beverage which was administrated for 14 days with 14 litre.To observed the result by gastroscope after 14 days.【Results】 Two patients who diagnosed as gastric cancer were treated by surgery and eight patients whose phytobezoars less than 5 cm×5 cm were treated successfully by endoscopic lithotripsy and endoscopic stone extraction technique.Other 19 patients were administrated with carbonated beverage.After two weeks 15 patients＇ phytobezoars were disappeared and other 4 patients＇ phytobezoars which easily extracted by snare were smaller than before.【Conclusions】 In our country the pathogenesis of gastric phytobezoar is relate with high tannins food taken by people,we strongly recommend that patients whose phytobezoars more than 5 cm ×5 cm should be treated by endoscope combination with administration carbonated beverage.