海博刀行内镜黏膜下剥离术治疗消化道黏膜下病变的效果

Effect of Hybrid knife for endoscopic submucosal dissection in the treatment of gastrointestinal submucosal lesions

目的探讨海博刀行内镜黏膜下剥离术(ESD)治疗消化道黏膜下病变的效果。方法选择80例2015年12月~2017年3月在本院治疗的消化道黏膜下病变患者,按随机原则分为海博刀组40例与对照组(使用常规IT刀或Dual刀)40例,两组病例均经常规检查无心肺功能障碍,无凝血功能障碍,无手术禁忌证。观察两组手术指标、疗效及并发症。结果海博刀组的住院时间为(9.42±3.44)d,短于对照组的(12.00±4.36)d(P<0.05);海博刀组的手术时间为(65.56±31.99)min,短于对照组的(104.37±42.38)min(P<0.01);两组的切除病变大小差异无统计学意义(P>0.05);海博刀组的腹痛发生率12.50%,低于对照组的32.50%,穿孔发生率为2.50%,低于对照组的15.00%(P<0.05),海博刀组的延迟出血率与对照组差异无统计学意义(P>0.05)。海博刀组的并发症总发生率为20.00%,低于对照组的52.50%(P<0.05);两组的疗效差异无统计学意义(P>0.05)。结论海博刀行ESD治疗消化道黏膜下病变,具有效果好、手术及住院时间短、并发症少等特点,值得临床推广应用。

Objective To investigate the effect of Hybrid knife for endoscopic submucosal dissection in the treatment of gastrointestinal submucosal lesions.Methods 80 hospitalized patients with gastrointestinal submucosal lesions treated in put hospital from December 2015 to March 2017 were selected and they were randomly divided into Hybrid knife group （n=40） and control group （using conventional IT knife or Dual knife,n=40）.The patients were all examined not have car- diopulmonary dysfunction,coagulation dysfunction and surgical contraindications.Operation index,curative effect and complications of two groups were observed.Results The hospitalization time was （9.42±3.44） d in Hybrid knife group,and it was significantly shorter than that in control group [（12.00±4.36）] d （P〈0.05）.Operative time was [（65.56±31.99） mini in HybridKnife group,and it was significantly shorter than that in control group [（104.37±42.38） min] （P〈0.01）.The size of the lesion between two groups had no significant difference （P〉0.05）.The incidence rate of complications of abdominal pain （12.50%）,perforation （2.50%） and it was shorter than that of control group （32.50%,15.00%）（P〈0.05）.There was no statistical difference of the incidence rate of delayed hemorrhage between two groups （P〉0.05）.The overall incidence rate of complications in the Hybrid knife group was 20.00%,which was significantly lower than the control group （52.50%） （P〈0.05）.There was no significant differenee of curative effect between two groups （P〉0.05）.Conclusion Hybrid knife for endoscopic submucosal dissection in the treatment of gastrointestinal submucosal lesions has the advantages of good effect,short operation and hospitalization time,less complications,and is worthy of clinical promotion and application.