两种内镜下取出枣核方法的医学经济学和安全性评价

Medical Economics and Safety Evaluation of two Methods of Taking out Jujube Seeds Under Endoscope

目的 评估内镜下应用透明帽结合取石网篮取出枣核及内镜下应用透明帽结合异物钳取出枣核这两种方法的医学经济学特点及其安全性。方法 将2020年9月至2021年9月疑似将枣核误吞入食管的患者纳入研究,共53例患者符合纳入研究的标准,将以上53例患者分为两组,A组29例,B组24例。A组患者于内镜下应用透明帽结合取石网篮取出枣核,B组患者于内镜下应用透明帽结合异物钳取出枣核。收集患者的年龄、性别、枣核位置、并发症情况、手术时长、是否成功取出和医院的平均成本等临床资料。结果 内镜下取出枣核的成功率为98.1%(52/53),剩余1.9%(1/53)需进行手术治疗。A组的严重并发症发生率低于B组(P=0.017),手术时长在两组之间无明显差别(P=0.647)。A组成功取出率高于B组(P=0.001)。医疗成本(包括全部成本、检查、治疗、影像检查和药物成本)在两组间差异无统计学意义(P>0.05在全部病例中)。结论 取石网蓝适用于内镜下枣核异物的取出,其取出成功率更高,严重并发症发生率更低,手术时间没有明显延长,医疗成本没有增加。

Objective To evaluate the medical and economic characteristics and safety of endoscopic transparent cap combined with stone basket and endoscopic transparent cap combined with foreign body forceps.Methods From September 2020 to September 2021,patients suspected of swallowing jujube nuclei into the esophagus by mistake were included in the study.A total of 53 patients met the inclusion criteria.The above 53 patients were divided into two groups.Patients in group A were taken out of jujube nuclei by transparent cap combined with stone basket under endoscope,and patients in group B were taken out of jujube nuclei by transparent cap combined with foreign body forceps under endoscope.Clinical data such as age,sex,jujube nucleus location,complications,operation duration,successful removal and average cost of the hospital were collected.Results A total of 29 cases in group A and 24 cases in group B.The success rate of removing jujube nucleus under endoscope was 98.1%(52/53),and the remaining 1.9%(1/53)needed surgical treatment.The incidence of serious complications in group A was lower than that in group B(P=0.017).There was no significant difference in operation time between the two groups(P=0.647).The successful removal rate of group A was higher than that of group B(P=0.001).There was no significant difference in medical cost(including total cost,examination,treatment,imaging examination and drug cost)between the two groups(P>0.05 in all cases).Conclusion Stone mesh blue is suitable for the removal of foreign bodies in jujube nucleus under endoscopy.It has a higher success rate,a lower incidence of serious complications,no significant extension of operation time and no increase in medical cost.