消化内镜黏膜下注射药物相关研究进展

Progress of endoscopic submucosal injection

黏膜下注射对于大多数内镜下黏膜切除术(endoscopic mucosal resection,EMR)和内镜黏膜下剥离术(endoscopic submucosal dissection,ESD)等内镜治疗是必不可少的。目前生理盐水仍是使用最多的也是相对安全的黏膜下注射液,但由于其不能维持较长黏膜抬高时间,对于较大病变需要反复注射。目前已经有了多种黏膜下注射液的方案,其中包括甘油果糖溶液、葡萄糖溶液、透明质酸、纤维蛋白原、琥珀酰化明胶、羟乙基淀粉以及新型复合凝胶。笔者对这些不同黏膜下注射液进行了简要综述,并分析了他们的优缺点。此外还简要分析了黏膜下注射液中加入的肾上腺素和染料的相关研究进展,并对未来研究提出了展望。

Submucosal injection is essential for most endoscopic treatments such as endoscopic mucosal resection(EMR),endoscopic submucosal dissection(ESD),etc.Normal saline is still the most commonly used and relatively safe submucosal injection at present;because it cannot maintain a long time of mucosal elevation,repeated injection is required for large lesions.A variety of submucosal injection schemes have been developed,including glycerol fructose solution,glucose solution,hyaluronic acid,fibrinogen,succinylated gelatin,hydroxyethyl starch,and new composite gel.We reviewed these different submucosal injections and analyzed their advantages and disadvantages.In addition,the research progress of epinephrine and dyes in submucosal injection was briefly analyzed,and the future research was prospected.