玻璃酸钠、甘油果糖和靛胭脂混合液在直肠小类癌内镜黏膜下剥离术中的应用

Application of sodium hyaluronate,glycerol fructose and indigo carmine mixture in small rectal carcinoids during endoscopic submucosal dissection

目的 观察玻璃酸钠、甘油果糖和靛胭脂混合液在内镜黏膜下剥离术(ESD)治疗直肠小类癌的疗效性及安全性.方法 85例直肠小类癌(直径≤10.0 mm)患者进行ESD,随机分为研究组和对照组.采用不同黏膜下注射液配伍,研究组为玻璃酸钠40 mg+甘油果糖8 mL+0.2%靛胭脂0.4 mL,对照组为甘油果糖10 mL+0.2%靛胭脂0.4 mL.比较两组手术时间、注射液用量、完整切除率、并发症及随访结果.结果 研究组手术时间、注射液用量明显少于对照组(P<0.01);两组完整切除率、并发症发生率差异无统计学意义(P>0.05);两组随访12个月均无病变残留和复发.结论 采用玻璃酸钠、甘油果糖和靛胭脂配制的混合液行直肠小类癌ESD可缩短手术时间,减少注射液用量,且不影响切除效果和并发症.

Objective To evaluate the efficacy and safety of sodium hyaluronate, glycerol fructose and indigo carmine mixture in small rectal carcinoids during endoscopic submucosal dissection(ESD). Methods Eighty-five patients with small rectal carcinoids(diameter ≤10.0 mm) undergoing ESD were randomly treated with submucosal injection of 40 mg sodium hyaluronate, 8 mL glycerol fructose and 0.4 mL 0.2% indigo carmine mixture(study group) or 10 mL glycerol fructose and 0.4 mL 0.2% indigo carmine mixture(control group). Operation time, injection volume, complete resection, complications, and follow-up results were compared between two groups. Results Operation time and injection volume were lower in study group than in control group(P<0.01), while complete resection and complications were insignificant between two groups(P>0.05). There was no residual disease or recurrence in two groups during follow-up of 12 months. Conclusion Sodium hyaluronate, glycerol fructose and indigo carmine mixture can decrease operation time and injection volume, and have no impact on complete resection and complications in small rectal carcinoids during ESD.