内镜下透明帽辅助处理食管上段异物的前瞻性研究

A prospective study of endoscopic transparent cap auxiliary treatment for upper esophageal foreign bodies

目的通过前瞻性研究分析内镜下透明帽辅助处理食管上段异物的应用价值。方法选取在我院就诊的食管上段嵌顿异物患者96例,随机分为试验组和对照组各48例。均通过颈部、胸部X线透视检查确定异物在食管上段的具体位置后,对照组在胃镜辅助下取出异物,试验组在内镜和透明帽辅助下取出异物。观察2组术中视野清晰度与患者耐受情况,记录异物取出操作时间,统计异物取出一次性成功率,并随访观察是否出现出血、穿孔等并发症。结果与对照组相比,试验组视野清晰度达A级的患者占71%显著高于对照组29%,耐受良好率为92%明显高于对照组69%,差异有统计学意义(P<0.05)。与对照组相比,试验组异物取出操作时间显著较短,差异有统计学意义(P<0.01)。试验组异物取出一次性成功率96%明显高于对照组81%,差异有统计学意义(P<0.05)。2组均未发生邻近器官损伤,试验组并发症发生率10%明显低于对照组31%,差异有统计学意义(P<0.05)。结论应用内镜下透明帽辅助处理食管上段异物视野清晰好,异物取出成功率高,并发症少,安全可靠。

Objective To analyze the application value of endoscopic transparent cap auxiliary treatment for upper esophageal foreign bodies by a prospective study. Methods A total of 96 patients with upper esophageal for- eign bodies were randomly divided into the experimental group （n = 48） and the control group （n = 48）. Through neck and chest X-ray examination, the specific locations of foreign bodies were determined. The foreign bodies of control group were removed under the gastroscope while the foreign bodies of the experimental group were removed with the help of endoscope and transparent cap. The clarity of visual field and patients＂ tolerance in the two groups were observed. The duration of foreign body removal and the success rate of once removal were re- corded, and the complications such as bleeding and perforation were observed. Results Patients with A-level vi- sion clarity in the experimental group accounted for 92% which was significantly higher than the control group （29%）, and the rate of good tolerance （92%） was also higher than the control group （69%） （ P 〈0.05）. The duration of foreign body removal in the experimental group was significantly shorter than that in the control group （ P 〈0.01）. The success rate of once removal in the experimental group （96~） was significantly higher than that in the control group （81%） （ P 〈0.05）. There was no adjacent organ injury in both groups, and the incidence rate of complications in the experimental group （10%） was significantly lower than that of the control group （31 %） （ P 〈0.05）. Conclusion The application of endoscopic transparent cap auxiliary treatment has advantages of high clarity of visual field, high success rate of foreign body removal and few complications. It is safe and relia- ble.