透明帽在胃镜诊治成人食管枣核嵌顿中应用

Gastroscopic diagnosis and treatment combined with transparent hood in adult patients with impacted common jujube seed of esophagus

目的探讨透明帽在胃镜诊治食管枣核嵌顿中的应用价值。方法选取沈阳军区总医院内镜科自2015年2月至2016年2月收治的31例食管枣核嵌顿患者,在透明帽的辅助下应用胃镜进行治疗,观察其临床疗效、嵌顿部位及并发症等。结果本组31例患者中,枣核嵌顿于食管入口12例(38.7%),食管上段10例(32.3%),食管中段7例(22.6%),食管下段2例(6.5%)。其中,食管嵌顿处损伤严重9例,经止血夹缝合后置入胃管治疗。嵌顿枣核取出的成功率为100%,未发生纵膈气肿、出血、穿孔等严重并发症。结论枣核易嵌顿于食管,特别是食管入口及上段,可在透明帽的辅助下应用胃镜安全取出,疗效确切、并发症少,是安全、有效的治疗方法。

Objective To clinically evaluate the method of attaching a transparent hood to the tip of the gastroscope in diag- nosis and therapy for adult patients with impacted common jujube seed of esophagus. Methods A retrospective study was performed on 31 cases of patients with impacted common jujube seed of esophagus who underwent gastroscopic therapy from December 2015 to February 2016. The clinical characteristics, impacted positions, and complications were analyzed by ap- proach of gastroscopic diagnosis and therapy combined with transparent hood in adult patients with impacted common jujube seed of esophagus. Results There were 31 cases of adult patients with impacted common jujube seed of esophagus, inclu- ding 12 cases（ 38.7% ）with impacted foreign bodies were found in introitus esophagus, 10 cases（ 32. 3% ）in upper esopha- gus, 7 cases （ 22. 6 % ） in mid-esophagus, and 2 cases （ 6. 5 % ） in lower esophagus. There were 9 eases in penetrating by com- mon jujube seed were closed with endoscope metal clips and inserted gastric canal. The success rate of the jujube date was 100 % and no serious complications such as mediastinal emphysema,haemorrhage and perforation. Conclusion The com- mon jujube seed is usually found incarceration esophagus especially introitus oesophagid and upper esophageal. The adult patients with impacted common jujube seed of esophagus could be diagnosed and treated by gastroscope with various appara- tus. It is an easy handling,less invasive, safe and effective treatment option for adult patients with impacted common jujube seed of esophagus by gastroscope.