Results of gastroscope bacterial decontamination by enzymatic detergent compared to chlorhexidine

AIM： To compare the efficacy of enzymatic detergent with chlorhexidine for gastroscope bacterial decontamination. METHODS： A prospective randomized controlled study was undertaken to evaluate the ability of these 2 agents to achieve high level disinfection in a gastroscope. A total of 260 samples were collected from 5 different gastroscopes. Manual cleaning was done for 10 min with these 2 agents separately （n = 130 each）. Then all specimens underwent 2% glutaraldehyde soaking for 20 min. After 70% alcohol was rinsed, sterile normal saline was flushed into each gastroscope channel and 40 mL of sample was collected. The sample was sent for aerobic bacterial culture after membrane was filtered. A colony count greater than 200 cfu/mL was considered significant. RESULTS： The positive culture rate was 4.6% in the enzymatic detergent arm and 3.1% in the chlorhexidine arm. Pseudomonas species were the main organism detected from both groups （60%）. Multiple organisms were found from 4 specimens （enzymatic detergent arm = 1, chlorhexidine arm = 3）. CONCLUSION： The contamination rate of both types of cleaning solution is equivalent.

Removal of esophageal benign tumors with gastroscope-assisted thoracoscopic surgery

The purpose of the study was to report our experience in the treatment of benign esophageal tu- mors with fiberoptic gastroscope-assisted thoracoscopic surgery. Methods： We retrospectively analyzed the clinical data of 24 consecutive patients （22 with esophageal leiomyoma and 2 with esophageal mesenchymoma） who underwent gas-troscope-assisted thoracoscopic surgery. There were 17 male and 7 female with a mean age of 36 years. The tumors were located in the upper and middle part of the esophagus in 17 cases and lower part in 7 cases. Results： All 24 procedures were successfully performed. The median operative time was 84 minutes and the median hospital stay was 7.5 days. One esophageal perforation due to dissection of a large lesion occurred intraoperatively, which was repaired by suturing. No deaths or other severe postoperative complications were encountered during the median follow-up period of 20.5 months. Conclusion： Gastroscope-assisted thoracoscopic surgery provides a safe and effective alternative to open thoracotomy in the treatment of benign esophageal tumors.

Percutaneous transhepatic intraportal biopsy using gastroscope biopsy forceps for diagnosis of a pancreatic neuroendocrine neoplasm:A case report

BACKGROUND Pancreatic neuroendocrine neoplasms(PNENs)are a rare group of neoplasms originating from the islets of the Langerhans.Portal vein tumor thrombosis has been reported in 33%of patients with PNENs.While the histopathological diagnosis of PNENs is usually based on percutaneous biopsy or endoscopic ultrasound-guided fine-needle aspiration(EUS-FNA),these approaches may be impeded by gastric varices,poor access windows,or anatomically contiguous critical structures.Obtaining a pathological diagnosis using a gastroscope biopsy forceps via percutaneous transhepatic intravascular pathway is an innovative method that has rarely been reported.CASE SUMMARY A 72-year-old man was referred to our hospital for abdominal pain and melena.Abdominal contrast-enhanced magnetic resonance imaging revealed a wellenhanced tumor(size:2.4 cm×1.2 cm×1.2 cm)in the pancreatic tail with portal vein invasion.Traditional pathological diagnosis via EUS-FNA was not possible because of diffuse gastric varices.We performed a percutaneous transportal biopsy of the portal vein tumor thrombus using a gastroscope biopsy forceps.Histopathologic examination revealed a pancreatic neuroendocrine neoplasm(G2)with somatostatin receptors 2(+),allowing systemic treatment.CONCLUSION Intravascular biopsy using gastroscope biopsy forceps appears to be a safe and effective method for obtaining a histopathological diagnosis.Although welldesigned clinic trials are required to obtain more definitive evidence,this procedure may help improve the diagnosis of portal vein thrombosis and related diseases.

Effect of modified ShengYangYiwei decoction on painless gastroscopy and gastrointestinal and immune function in gastric cancer patients

BACKGROUND Painless gastroenteroscopy is a widely developed diagnostic and treatment technology in clinical practice.It is of great significance in the clinical diagnosis,treatment,follow-up review and other aspects of gastric cancer patients.The application of anesthesia techniques during manipulation can be effective in reducing patient fear and discomfort.In clinical work,the adverse drug reactions of anesthesia regimens and the risk of serious adverse drug reactions are increased with the increase in propofol application dose application dose;the application of opioid drugs often causes gastrointestinal reactions,such as nausea,vomiting and delayed gastrointestinal function recovery,after examination.These adverse effects can seriously affect the quality of life of patients.AIM To observe the effect of modified ShengYangYiwei decoction on gastrointestinal function,related complications and immune function in patients with gastric cancer during and after painless gastroscopy.METHODS A total of 106 patients with gastric cancer,who were selected from January 2022 to September 2022 in Xiamen Traditional Chinese Medicine Hospital for painless gastroscopy,were randomly divided into a treatment group(n=56)and a control group(n=50).Before the examination,all patients fasted for 8 h,provided their health education,and confirmed if there were contraindications to anesthesia and gastroscopy.During the examination,the patients were placed in the left decubitus position,the patients were given oxygen through a nasal catheter(6 L/min),the welling needle was opened for the venous channel,and a multifunction detector was connected for monitoring electrocardiogram,oxygen saturation,blood pressure,etc.Naporphl and propofol propofol protocols were used for routine anesthesia.Before anesthesia administration,the patients underwent several deep breathing exercises,received intravenous nalbuphine[0.nalbuphine(0.025 mg/kg)],followed by intravenous propofol[1.propofol(1.5 mg/kg)]until the palpebral reflex disappeared,and after no response,gastroscopy was performed.If palpebral reflex disappeared,and after no response,gastroscopy was performed.If any patient developed movement,frowning,or hemodynamic changes during the operation(heart rate changes during the operation(heart rate increased to>20 beats/min,systolic blood pressure increased to>20%of the base value),additional propofol[0.propofol(0.5 mg/kg)]was added until the patient was sedated again.The patients in the treatment group began to take the preventive intervention of Modified ShengYangYiwei decoction one week before the examination,while the patients in the control group received routine gastrointestinal endoscopy.The patients in the two groups were examined by conventional painless gastroscopy,and the characteristics of the painless gastroscopies of the patients in the two groups were recorded and compared.These characteristics included the total dosage of propofol during the examination,the incidence of complications during the operation,the time of patients'awakening,the time of independent activities,and the gastrointestinal function of the patients after examination,such as the incidence of reactions such as malignant vomiting,abdominal distension and abdominal pain,as well as the differences in the levels of various immunological indicators and inflammatory factors before anesthesia induction(T0),after conscious extubation(T1)and 24 h after surgery(T2).RESULTS There was no difference in the patients’general information,American Society of Anesthesiologist classification or operation time between the two groups before treatment.In terms of painless gastroscopy,the total dosage of propofol in the treatment group was lower than that in the control group(P<0.05),and the time of awakening and autonomous activity was significantly faster than that in the control group(P<0.05).During the examination,the incidence of hypoxemia,hypotension and hiccups in the treatment group was significantly lower than that in the control group(P<0.01).In terms of gastrointestinal function,the incidences of nausea,vomiting,abdominal distension and abdominal pain in the treatment group after examination were significantly lower than those in the control group(P<0.01).In terms of immune function,in both groups,the number of CD4+and CD8+cells decreased significantly(P<0.05),and the number of natural killer cells increased significantly(P<0.05)at T1 and T2,compared with T0.The number of CD4+and CD8+cells in the treatment group at the T1 and T2 time points was higher than that in the control group(P<0.05),while the number of natural killer cells was lower than that in the control group(P<0.05).In terms of inflammatory factors,compared with T0,the levels of interleukin(IL)-6 and tumor necrosis factor-alpha in patients in the two groups at T1 and T2 increased significantly and then decreased(P<0.05).The level of IL-6 at T1 and T2 in the treatment group was lower than that in the control group(P<0.05).CONCLUSION The preoperative use of modified ShengYangYiwei decoction can optimize the anesthesia program during painless gastroscopy,improve the gastrointestinal function of patients after the operation,reduce the occurrence of examination-related complications.

Efficacy and safety of gastroscopic hemostasis in the treatment of acute gastric hemorrhage: A meta-analysis

BACKGROUND Gastric cancer(GC)is a malignant tumor with a high incidence and mortality rate worldwide for which acute bleeding is a common clinical complication.Gastro-scopic hemostasis is an important method for treating acute bleeding in GC;however,its efficacy and safety remain controversial.AIM To systematically analyze the efficacy and safety of gastroscopic hemostasis for the treatment of acute gastric hemorrhage.METHODS The PUBMED,Web of Science,Wiley Library,EMBASE,Wanfang,CNKI,and VIP databases were searched for studies related to gastroscopic hemostatic treatment for acute GC published through February 20,2023.The literature was screened according to the inclusion and exclusion criteria,data were extracted,and lite-rature quality was evaluated.The meta-analysis was performed using RevMan software(version 5.3),while Begg’s test for publication bias was performed using Stata 13.0 software.RESULTS Six randomized controlled trials and two retrospective analyses were retrieved.Five studies had a low,two had an uncertain,and one had a high risk of bias.Compared with the control group,the hemostatic rate of gastroscopic hemostasis was increased[relative risk(RR)=1.24;95%confidence interval(CI):1.08 to 1.43;P=0.003];the rate of rebleeding(RR=0.27;95%CI:0.09 to 0.80;P=0.02),rate of surgery transfer(RR=0.16;95%CI:0.06 to 0.43;P=0.0003),serum C-reactive protein level[mean difference(MD)=-5.16;95%CI:-6.11 to 4.21;P<0.00001],interleukin-6 level(MD=-6.37;95%CI:-10.33 to-2.42;P=0.002),and tumor necrosis factor-αlevel(MD=-2.29;95%CI:-4.06 to-0.52;P=0.01)were decreased;and the quality of life improvement rate was increased(RR=1.95;95%C I=1.41-2.71;P<0.0001).Begg’s test revealed no significant publication bias.CONCLUSION The efficacy and safety of endoscopic hemostasis were higher than those of the control group,suggesting that it is an effective treatment for acute GC hemorrhage.

Value of gastroscopy combined with serum pepsinogen in the diagnosis of high risk Hp related gastric cancer

Objective:To explore the value of Helicobacter pylori antibody (Hp-IgG) and serum pepsinogen (PG) combined with gastroscopy for screening early gastric cancer and precancerous lesions in high-risk groups, so as to provide references for early clinical prevention and diagnosis.Methods: A retrospective analysis of our hospital from December 2014 to December 2017 were elderly patients with gastric cancer 304 cases, selected admitted 122 cases of elderly patients with gastric precancerous lesion (divided into superficial gastritis group, 70 cases of chronic atrophic gastritis group 52 cases) and 156 cases to the hospital in healthy volunteers as the control group. The status and the positive rate of Helicobacter pylori 13C urea breath test and compared two groups of patients with infection;using enzyme-linked immunosorbent assay of serum pepsinogen I (PG I), II (PG II) and pepsin Hp-IgG quantitative and qualitative diagnosis of individual and combined diagnostic efficiency and the comparison of three kinds of index.Results: The four groups were compared, the serum PG level of I from high to low were superficial gastritis group, normal control group, atrophic gastritis group and gastric cancer group, the differences were statistically significant;serum PG II levels from high to low in gastric cancer group and superficial gastritis group. Atrophic gastritis group, normal control group, the differences were statistically significant. Compared with the three groups, the positive rate of Hp-IgG was 90.7% in the gastric cancer group, 45.6% in the superficial gastritis group, 52.5% in the atrophic gastritis group, and the gastric cancer group was higher than that in the precancerous lesion group, but there was no difference between the precancerous lesions group. In terms of diagnostic efficacy, the specificity and sensitivity of Helicobacter pylori combined with pepsinogen were higher than those of the single diagnosis. Conclusion: Hp-IgG and PG combined with gastroscopy in screening high-risk gastric cancer and its precancerous lesions are of high specificity, high sensitivity and can be popularized in clinic.

Plastic tube-assisted gastroscopic removal of embedded esophageal metal stents: A case report

A patient with stent embedding after placement of an esophageal stent for an esophagobronchial fistula was treated with an ST-E plastic tube inserted into the esophagus to the upper end of the stent using gastroscopy.The gastroscope was guided into the esophagus through the ST-E tube,and an alligator forceps was inserted into the esophagus through the ST-E tube alongside the gastroscope.Under gastroscopy,the stent wire was grasped with the forceps and pulled into the ST-E tube.When resistance was met during withdrawal,the gastroscope was guided further to the esophageal section where the stent was embedded.Biopsy forceps were guided through a biopsy hole in the gastroscope to the embedded stent to remove silicone membranes and connection threads linking the Z-shaped wire mesh.While the lower section of the Z-shaped stent was fixed by the biopsy forceps,the alligator forceps were used to pull the upper section of the metal wire until the Z-shaped metal loops elongated.The wire mesh of the stent was then removed in stages through the ST-E tube.Care was taken to avoid bleeding and perforation.Under the assistance of an ST-E plastic tube,an embedded esophageal metal stent was successfully removed with no bleeding or perforation.The patient experienced an uneventful recovery after surgery.Plastic tube-assisted gastroscopic removal of embedded metal stents can be minimally invasive,safe,and effective.

Gastroscopic Observation of 22 Cases with Special Types of Early Gastric Cancer

Twenty-two cases of special types of early gastric cancer were by endoscopy with biopsy in our hospital.There cases were cancers simulating gastritis, 6 cases were ulcers with malignant change,2 cases of gastric angle ulcer in scar stage with malignant change, 11 case of advanced gastric cancer.The characteristics of these lesions were described and analyzed in oredr to study further the occurvence and development of he gastric cancer and to recognize some special types of early gastric cancer and early diagnosis of the disease.

ZTE Introduces World's First Ultra-Slim Big-Screen BMP 3G Smartphone

ZTE Corporation, a leading global provider of telecommunications equipment and network solutions, together with Qualcomm, introduced the world＇ s first ultra-slim big-screen BMP 3G smartphone--ZTE Bingo at the 2010 GSMA Mobile World Congress,. In addition, ZTE is showcasing its 5 Android smartphone models for the first time. With the availability of Linux, Windows Mobile and OMS-platform mobile phones, ZTE is one of the few mobile phone manufacturers to offer smartphones for a variety of mobile operating systems.

Economic Evaluation of Gastroscopy for Detecting Gastric Cancer in Chinese Natural Population

Objective To evaluate the economy of detecting gastric cancer by electronic gastroscope in Chinese natural population of different ages and genders.Methods A Markov model was constructed for the population,including both men and women of different ages.The model cycle was one year and the simulation time was 60 years.The cost-effectiveness of electronic gastroscopy in detecting gastric cancer of general population in China was analyzed from the perspective of the whole society,and the stability of the results was verified by sensitivity analysis.Results and Conclusion For the general population,the incremental cost-effectiveness ratio(ICER)of gastric cancer screening from the age of 50 is 50143 yuan/QALY(quality-adjusted life-year),which is less than two times of per capita gross domestic product(GDP)compared with the screening from the age of 55.For men who start gastric cancer screening at the age of 50,the ICER is 38525 yuan/QALY,which is less than two times of per capita GDP,and it is economical.For women who start the screening from the age of 55,the ICER is 47814 yuan/QALY,which is less than two times of per capita GDP,so it is economical.The results of sensitivity analysis are consistent with the conclusions of basic analysis,and the results of basic analysis are stable.For the general population,it is more economical to start gastric cancer screening from the age of 50,while for men and women,it is more economical to start gastric cancer screening from the age of 50 and 55,respectively.

Comparative Analysis of the Value of Gastroscopic Biopsy and Surgical Pathology in the Diagnosis of Gastric Cancer

Objective:To explore and analyze the diagnostic value of gastroscopic biopsy and surgical pathology in improving the diagnostic accuracy of gastric cancer.Methods:From May 2019 to June 2020,80 patients with gastric cancer treated in Shuyang Xiehe Hospital were selected and divided into two groups,a control group and a study group,with 40 cases in each group,based on the examination method individually selected by the patients.The patients in the control group were investigated via gastroscopy,while those in the study group were investigated by surgical pathology.The diagnostic values of the two methods were compared and analyzed.Results:The diagnostic accuracy of patients in the study group was 100%,which was higher than that of the control group.The tissue type,lesion morphology,and cancer differentiation of the study group were better than those of the control group.There was significant difference between the two methods(P<0.05).Conclusion:Surgical and pathological examination can improve the diagnostic accuracy of gastric cancer,comprehensively analyze the patient’s condition,and provide corresponding theoretical basis for follow-up treatment,so that patients can obtain more active and effective treatment,reduce pain,and improve their quality of life.

磁控胶囊内镜的临床应用

目的 回顾性分析磁控胶囊内镜联合电子胃镜在临床中的应用,包括对胃部及小肠常见疾病的诊断与筛查。方法 收集2018年9月至2022年8月在河北省人民医院进行磁控胶囊内镜检查的患者910例,分析磁控胶囊内镜诊断的准确性,另对此910例患者进行回顾性分析,在不同年龄组方面;以季节分为春夏秋冬4组,分析不同疾病的发病率的差异。结果 910例患者中465例患者3个月内进行过电子胃镜检查,磁控胶囊内镜对于食管的诊断符合率差异有统计学意义(P<0.05),胃部及十二指肠诊断符合率差异无统计学意义(P>0.05)。另对此910例患者进行回顾性分析,在不同年龄组方面,部分疾病的检出率组间比较差异有统计学意义(P<0.05),以中老年组最多见;以性别分组,进行回顾性统计学分析,慢性非萎缩性胃炎和胃息肉两种疾病男性检出率均低于女性,差异有统计学意义(P<0.05);反流性食管炎、十二指肠溃疡、胃溃疡女性检出率均低于男性,差异有统计学意义(P<0.05)。对910例患者的小肠的检查进行统计学分析,其中小肠肿物的检出率为3/910,小肠出血的检出率为2/910,小肠多发淋巴管扩张289/910,回肠多发淋巴滤泡增生的检出率为216/910,小肠炎的检出率为26/910,小肠多发血管扩张检出率为1/910。结论 磁控胶囊内镜应用于胃部检查及十二指肠检查的结果与电子胃镜的检出率相似,食管的诊断较电子胃镜检查有差异,对910例患者进行胃部检查进行回顾性分析,中老年人疾病的发病率更高,男性胃病疾病的发病率高于女性,可用于胃部疾病的筛查,磁控胶囊内镜检查亦可用于小肠疾病的诊断。

利多卡因气雾剂在老年病人无痛胃镜诊疗中的应用

目的观察利多卡因气雾剂在老年病人无痛胃镜诊疗中的安全性和有效性。方法选择2022年6—12月我院内镜中心行无痛胃镜诊疗的年龄>65岁、美国麻醉医师学会分级Ⅰ~Ⅲ级的老年病人100例。按照随机数表法分成A、B组(n=50),A组先采用利多卡因气雾剂咽喉部喷雾表面麻醉,然后采用瑞芬太尼+丙泊酚组合静脉麻醉;B组直接采用瑞芬太尼+丙泊酚组合静脉麻醉。记录并比较2组术前基础和术中最低的平均动脉压(MAP)、心率(HR)、SpO_(2),胃镜成功置入时丙泊酚的用量和丙泊酚总用量,胃镜成功置入时的Ramsay镇静评分,苏醒时间以及术中不良反应的发生情况。结果与B组相比,A组胃镜成功置入时丙泊酚的用量和总用量显著减少(P<0.05),术中最低MAP、HR、SpO_(2)显著增高(P<0.05),Ramsay镇静评分和苏醒时间显著减少(P<0.05),术中呛咳体动、呼吸抑制、低血压等不良反应发生率显著降低(P<0.05)。结论利多卡因气雾剂能够显著减少丙泊酚的用量,同时呛咳、呼吸抑制、低血压和HR降低等不良反应发生率显著降低,病人苏醒更快,是适合老年病人无痛胃镜诊疗的一种安全有效的麻醉方法。

氟马西尼改善丙泊酚无痛胃肠镜后复苏、认知功能的效果

目的 探究氟马西尼改善丙泊酚无痛胃肠镜检查后患者复苏、认知功能的效果。方法 依据随机数字表法,将2022年1—9月在南昌市第一医院接受无痛胃肠镜检查的80例患者分为两组,每组40例,在患者无痛胃肠镜检查完成后,对照组给予生理盐水(5 ml),观察组给予氟马西尼(0.3~0.5 mg),对比组间睁眼时间、清醒时间、不良反应、复苏和认知功能、应激状态。结果 观察组睁眼时间[(4.83±0.55)min vs.(6.13±1.27)min,P <0.001]、清醒时间[(6.79±1.44)min vs.(9.38±2.16)min,P <0.001]均短于对照组。干预1 h后,两组患者复苏、认知功能评分均高于干预前,观察组评分高于对照组(P <0.05);两组手术应激指数(SSI)均高于干预前(P <0.05),观察组SSI高于对照组(62.34±3.16 vs.57.88±1.24,P <0.001)。两组不良反应发生率差异无统计学意义(P> 0.05)。结论 氟马西尼用于丙泊酚无痛胃肠镜检查后,对于患者复苏、认知功能、应激状态及不良反应发生情况方面均有改善作用,在临床应用中具有重要价值。

胃癌高风险人群胃镜筛查行为的质性研究

目的:分析胃癌高风险人群胃镜筛查行为的影响因素。方法:采用目的抽样法,选取2023年9月至10月在南昌市某三甲医院门诊就诊的胃癌高危患者作为研究对象。对研究对象进行半结构式访谈,采用Colaizzi七步法对获得的资料进行整理、分析并提炼出主题。结果:共提炼出7个主题,分别为胃癌高风险人群相关概念、胃癌疾病知识、胃镜筛查认知、对胃镜检查存在负性情绪、缺乏知识获取途径、组织经济因素、需求因素。结论:胃癌高风险人群胃镜筛查行为受多种因素影响,促进胃癌高风险人群进行胃镜筛查应加强胃癌高风险人群识别,推进胃癌及筛查知识的普及,完善医疗政策,提高内镜诊疗水平。

布托啡诺在无痛胃镜中的应用及研究进展

近年来,我国胃肠道疾病的发病率逐渐增加,无痛胃镜检查则是最可靠、最常用的诊断方法。布托啡诺与丙泊酚联合应用,具有良好的镇痛作用,且不良反应少,已广泛应用于无痛胃镜检查中。但是对于不同年龄阶段患者布托啡诺的应用剂量是否一致仍未可知,本研究旨在探索布托啡诺在不同年龄阶段患者接受无痛胃镜的应用剂量,为临床用药提供参考依据。

Cronkhite-Canada综合征2例并文献复习

目的探讨Cronkhite-Canada综合征(Cronkhite-Canada syndrome,CCS)的临床特征、治疗方法及预后。方法收集南昌大学第四附属医院消化内科收治的2例CCS患者的临床资料,结合相关文献,对其诊疗、转归以及长期消化内镜的随访资料进行分析。结果2例患者均以胃息肉病变为突出表现。例1于2013年5月确诊CCS并结肠癌,予外科手术、内镜下部分息肉切除术及营养支持治疗后,患者营养状况明显好转,确诊后2年间进行6次胃镜随访,2015年4月确诊胃窦恶性溃疡,2017年7月死亡。例2于2019年6月入院时诊断不明,结合患者其他症状及体征,诊断为CCS,采用激素治疗效果不佳,后因病情进展行全胃切除,术后随访2年,目前病情稳定。结论CCS病情多呈进行性加重,具有恶变趋势,治疗上以糖皮质激素为主,必要时可考虑切除严重病变部位,长期消化内镜下随访有助于诊断疾病及发现早期癌变。

延迟清洗时间对胃镜清洗消毒质量的影响

目的评价不同溶液预处理后延迟清洗时间对胃镜清洗消毒质量的影响。方法根据析因设计表,将预处理清洗液(A因素):多酶清洗液(A_(1))、清水(A_(2));延迟清洗时间(B因素):预处理后0 min(B_(1))、预处理后30 min(B_(2))、预处理后1 h(B_(3))、预处理后3 h(B_(4))两因素全面交叉为8组(A_(1)B_(1)、A_(1)B_(2)、A_(1)B_(3)、A_(1)B_(4)、A_(2)B_(1)、A_(2)B_(2)、A_(2)B_(3)、A_(2)B_(4))。按照使用胃镜先后顺序,使用随机数字表法将2023年5—9月某三甲医院消化内镜中心使用后的96条胃镜分配至各组,每组12条胃镜,于预处理后、清洗前、清洗后和消毒后四个时间点取样,除A_(1)B_(1)、A_(2)B_(1)组缺少放置时间后清洗前采样外(两组胃镜各采样3次),其余每组所有胃镜均采样4次,共计360份标本。在预处理后各延迟清洗时间段采用管腔检测仪观察活检腔道内部情况,并对胃镜后续再处理流程进行采样,比较预处理后、清洗前后、消毒后胃镜微生物情况。结果多酶清洗液和清水预处理后,微生物学检测结果差异无统计学意义(P>0.05)。延迟清洗时间内活检腔道一直处于潮湿状态。A、B两因素在延迟清洗前后、消毒后的微生物学检测结果比较,差异均无统计学意义(均P>0.05),A、B两因素间也不存在交互效应。两种清洗液预处理后胃镜菌落数分布及消毒合格率比较,差异也均无统计学意义(均P>0.05)。结论预处理后延迟30 min、1 h、3 h清洗对胃镜清洗消毒质量均没有影响,在临床工作不可周转的情况下,应立即清洗,但当清洗消毒工作量大,无法及时清洗时,可有一定的清洗缓冲时间,以不超过3 h为宜。

70°硬管喉镜在下咽部及食管上段异物取出术中的应用

目的探讨70°硬管喉镜在下咽部及食管上段异物取出术中的应用效果。方法回顾性分析2022年1月至2023年2月198例下咽部及食管上段异物患者的临床资料。其中下咽部异物121例;食管上段异物77例。分析70°硬管喉镜在不同部位异物取出术中的应用效果。结果下咽部异物患者中经70°硬管喉镜取出120例,电子胃镜取出1例;食管上段异物患者中经70°硬管喉镜取出19例,电子胃镜取出41例;电子胃镜检查未找到5例,食管镜手术取出3例,自行脱落9例。在下咽部异物的类型中鱼刺最常见,占86.78%;在食管上段异物类型中,鱼刺占38.96%,各类骨头占41.56%。结论70°硬管喉镜在下咽部异物及食管上段异物的应用中具有方便快捷、视野暴露好等优势。对于异物暴露清楚且配合程度较好的患者,尤其是下咽部与食管第6颈椎平面以上异物可以优先考虑应用70°硬管喉镜取出。

胃镜下钛夹标记在不可切局部晚期食管癌患者进行根治性调强放疗时靶区勾画的价值研究

目的:探讨胃镜下钛夹标记在不可切局部晚期食管癌患者进行根治性调强放疗时靶区勾画的价值。方法:选取2021年1~12月我院收治行根治性调强放疗的不可切局部晚期食管癌患者150例为研究对象,按随机数字表法分为对照一组、对照二组及观察组,每组各50例,比较3组患者靶区勾画效果,评估放疗6周后近期疗效,统计不良反应,随访至2024年6月,分析远期预后,评定记录无进展生存期(FPS)及总生存期(OS)情况。结果:3组患者病灶长度、GTV、CTV比较,差异有统计学意义(P<0.05),观察组、对照二组患者病灶长度、GTV、CTV均高于对照一组患者(P<0.05),观察组与对照二组患者病灶长度、GTV比较,差异无统计学意义(P>0.05),但观察组患者CTV低于对照二组患者(P<0.05);3组患者治疗总有效率比较,差异有统计学意义(P<0.05),且观察组患者总有效率为96.00%,高于对照一组患者的84.00%(P<0.05);3组患者不良反应情况比较,差异无统计学意义(P>0.05);随访截至2024年6月,对照一组患者PFS 1~17个月(9个月)、OS 2~31个月(15个月);对照二组患者PFS 1~16个月(10个月)、OS 2~34个月(15个月);观察组患者PFS 3~20个月(12个月)、OS 3~44个月(22个月),经Kaplan-Meier生存曲线显示,观察组患者PFS、OS长于对照一组和对照二组患者(P<0.05)。结论:胃镜下钛夹标记有助于精准勾画不可切局部晚期食管癌患者靶区,可避免食管钡餐造影定位后放疗剂量不充分以及CT扫描定位后正常器官受照剂量增多的影响,可获可靠近期疗效,且远期预后良好。