盐酸戊乙奎醚注射液在内镜黏膜下剥离术中的应用效果研究

A Study on the Effectiveness of Penehyclidine Hydrochloride Injection in Endoscopic Submucosal Dissection

目的:探讨在内镜黏膜下剥离术(ESD)中应用盐酸戊乙奎醚注射液的效果。方法:选取2019年9月-2021年6月于锦州医科大学附属第一医院消化内镜中心接受ESD治疗,并通过病理学诊断确诊为结肠早癌和癌前病变的120例患者为研究对象,随机分为三组,各40例。按组别静脉注射等容量生理盐水(研究组1)、山莨菪碱0.01 mg/kg(研究组2)、盐酸戊乙奎醚0.01 mg/kg(研究组3),后行ESD治疗。比较三组患者血流动力学指标、ESD手术时间、术中剥离病灶时间、肠蠕动情况及并发症发生率。结果:麻醉成功后5 min,研究组3心率、收缩压均低于研究组1和研究组2,血氧饱和度(SPO2)高于研究组1和研究组2,舒张压低于研究组2,差异有统计学意义(P<0.05)。检查结束时,研究组3心率低于研究组2,收缩压低于研究组1和研究组2,舒张压高于研究组1,SPO2高于研究组1和研究组2,差异均有统计学意义(P<0.05)。研究组3患者ESD手术时间和术中剥离病灶时间均短于研究组1和研究组2,差异有统计学意义(P<0.01)。研究组3肠道蠕动情况明显优于研究组1和研究组2,差异有统计学意义(P<0.01)。研究组3并发症发生率低于研究组1和研究组2,差异有统计学意义(P<0.05)。结论:在ESD中应用盐酸戊乙奎醚,可改善患者血流动力学指标,缩短手术时间,抑制术中肠蠕动,降低并发症发生率,值得临床推广。

Objective:To study the effectiveness of penehyclidine hydrochloride injection in endoscopic submucosal dissection(ESD).Methods:The patients were selected to receive ESD treatment at the Gastroenterology Endoscopy Center of the First Affiliated Hospital of Jinzhou Medical University from September 2019 to June 2021.And 120 patients who were diagnosed as early colon cancer and precancerous lesions by pathological diagnosis were the study subjects,and randomly divided into three groups of 40 cases each.Intravenous injection of equal volume saline(study group 1),scopolamine 0.01 mg/kg(study group 2),and penehyclidine hydrochloride 0.01 mg/kg(study group 3)was administered by group,followed by ESD treatment.The hemodynamic indexes,ESD operation time,intraoperative debridement time of the lesion,intestinal motility and complication rate were compared among the three groups.Results:Five min after successful anesthesia,heart rate and systolic blood pressure in study group 3 were lower than those in study group 1 and study group 2,blood oxygen saturation(SPO_(2))was higher than those in study group 1 and study group 2,and diastolic blood pressure was lower than that in study group 2,with statistically significant differences(P<0.05).At the end of the examination,study group 3 had a lower heart rate than study group 2,a lower systolic blood pressure than study group 1 and study group 2,a higher diastolic blood pressure than study group 1,and a higher SPO_(2) than study group 1 and study group 2,all with statistically significant differences(P<0.05).The time of ESD surgery and intraoperative lesion peeling time were shorter in study group 3 patients than in study group 1 and study group 2,and the differences were statistically significant(P<0.01).Bowel motility was significantly better in study group 3 than in study group 1 and study group 2,and the difference was statistically significant(P<0.01).The incidence of complications was lower in study group 3 than in study group 1 and study group 2,and the difference was statistically significant(P<0.05).Conclusion:The application of penehyclidine hydrochloride in ESD can improve the hemodynamic index of patients and shorten the operation time,inhibit intraoperative intestinal motility and reduce the incidence of complications,which is worthy of clinical promotion.