金属夹联合新型尼龙绳缝合胃壁全层缺损临床应用-clinical application of metal clips combined with new nylon cord suture for gastric wall full-thickness defect.docxVIP

金属夹联合新型尼龙绳缝合胃壁全层缺损的临床应用中文摘要金属夹联合新型尼龙绳缝合胃壁全层缺损的临床应用中文摘要目的探讨金属夹联合新型尼龙绳缝合胃壁全层缺损的可行性及安全性，并比较乐奥尼龙绳与Olympus尼龙绳的效果差异。方法32例胃底粘膜下肿瘤随机分为两组行内镜全层切除术（EFR），研究组14 例予乐奥尼龙绳缝合胃壁缺损，对照组18 例予Olympus 尼龙绳缝合胃壁缺损，比较两组闭合成功率、闭合耗时、操作所用金属夹及尼龙绳数目、并发症情况、创面愈合率。结果两组均顺利完成EFR 手术，闭合成功率均为100％，差异无统计学意义（P0.05）；研究组耗时（13.86±4.62）min，对照组耗时（18.28±6.48）min，研究组比对照组所用时间短，差异有统计学意义（P0.05）；研究组与对照组应用金属夹分别为（9.43±4.09）枚和（9.67±3.61）枚，尼龙绳分别为（1.00±0.00）枚和（1.06±0.24）枚，差异均无统计学意义（P0.05）；研究组和对照组术中分别有1例和2 例因气腹明显予腹腔穿刺抽气治疗，差异无统计学意义（P0.05）；两组术后24小时查腹部立位平片均示不同程度膈下游离气体，因量少及患者症状不明显未予穿刺抽气治疗，全胸片均无皮下气肿、气胸、纵膈气肿；两组患者术后均未见迟发出血及腹腔感染症状。术后1个月复查胃镜，两组创面均见愈合良好，可见疤痕，部分患者金属夹及尼龙绳未脱落，术后2个月复查胃镜，创面完全愈合，创面光滑，两组差异无统计学意义（P0.05）。结论金属夹联合新型尼龙绳缝合EFR术后胃壁全层缺损安全有效，值得临床推广。【关键词】金属夹；尼龙绳；内镜全层切除术；粘膜下肿瘤作者：张磊指导老师：李锐英文摘要金属夹联合新型尼龙绳缝合胃壁全层缺损的临床应用Endoscopicclosureofgastricfull-thickness defects by application ofmetallicclipsandnew typeendoloopAbstractObjectiveTostudythefeasibilityandsafetyofthemetallicclipsandendoloopsfor gastricfull-thicknessdefectscausedbyEFR，andcomparethedifferenceofLeCampTMendoloopand Olympusendoloop .Methods32 patientswith submucosal tumors in gastric fundus were randomly dividedintotwogroups----study groupwith14patientsandcontrolgroupwith18patients,allpatientsweretreatedwithendoscopicfull-thicknessresection．Aftertheoperation，metallicclipsandLeCampTMendoloopswereusedtoclosethegastricdefectinthestudy group,metallicclipsandOlympusendoloopswereusedtoclosethegastricdefectsinthecontrolgroup．Theclosuresuccessrate、closuretime、numbersofmetallicclipsandendoloops、complications andthewound healingratewerecompared．ResultsAll patients underwent endoscopic full-thickness resection .The closure success rate of the two groups were both 100%, the difference was not statisticallysignificant(P0.05).Theclosuretimeinstudygroupandcontrolgroupwere（13.86±）minand（18.28±6.48）min，thedifferencewas statisticallysignificant (P0.05). Thenumbersofmetallicclipsinstudy groupandcontrolgroupwere（9.43±4.09）and（9.67±3.61）（P0.05）.Thenumbersofendoloopsinstudygroupandcontrolgroup were（1.0