外套管在内镜下异物取出术中的应用价值

柴建中

（陕西省森工医院消化内科，陕西 西安，710300）

浏览次数：94次 下载次数：315次

摘要：

目的 探讨外套管在内镜下异物取出术中的价值。方法 回顾性分析陕西省森工医院于2014年1月1日至2016年1月1日收治的200例食管异物患者的临床资料，以内镜下检查和治疗中是否加用外套管分为试验组（96例）和对照组（104例），分 析比较两组患者治疗效果及并发症发生率。结果 试验组患者全部成功取出异物，其中，2例出现食管黏膜损伤。对照组患者中，成功取出异物77例，未能将异物经口取出27例；其中，将异物由食管推送入胃腔中8例，行外科手术治疗1例，另18例发生嵌顿未能取出；对照组104例患者中，有35例存在不同程度的食管上段黏膜的损伤及出血。试验组异物取出成功率为 100.00%，并发症发生率为2.08%；对照组异物取出成功率为74.04%，并发症发生率为33.65%，两组比较，差异显著（P<0.05）。结论 外套管在内镜下异物取出术中可以提高治疗的成功率，减少异物对食管黏膜的损伤，降低并发症的发生率，值得临床推广。

关键词：内镜；外套管；消化道异物

中图分类号：R656文献标志码：A文章编号：2096-1413(2017)18-0066-02

Application value of endoscopic management of ingested foreign bodies under overtube
CHAI Jian-zhong
(Department of Gastroenterology, Shaanxi Forest Industry Hospital, Xi``an 710300, China)

ABSTRACT: Objective To analyze the application value of the endoscopic management of ingested foreign bodies under overtube. Methods The clinical data of 200 patients with ingested foreign bodies in esophagus treated in Shaanxi Forestry Hospital from January 1, 2014 to January 1, 2016 was analyzed retrospectively, The patients were divided into the experimental group (96 cases) and the control group (104 cases) according to whether or not used the outer tube under the endoscope examination and the treatment. The treatment effects and complication incidence rates of the two groups were analyzed and compared. Results All the patients in the experimental group were successfully removed. Among them, 2 cases showed esophageal mucosal damage. In the control group, 77 foreign bodies were successfully removed, and 27 cases failed to be removed through the mouth. Among them, 8 cases of foreign bodies were pushed into the stomach cavity by esophagus, 1 case was treated with surgery, 18 cases were incarcerated and could not be removed. Of the 104 patients in the control group, 35 patients suffered from varying degrees of injury and bleeding of the upper esophageal mucosa. The successful rate of foreign body removal in the experimental group was 100.00%, and the complication rate was 2.08%. The success rate of foreign body removal in the control group was 74.04% , and the complication rate was 33.65% . The differences between the two groups were significant (P<0.05). Conclusion The endoscopic management of ingested foreign bodies under overtube can improve the success rate of treatment, reduce the damage of foreign body to esophageal mucosa and complications, which is worthy of clinical promotion.
KEYWORDS: endoscopy; overtube; foreign bodies in digestive tract

参考文献：
[1] 彭檀,刘柏,范传玲,等.经内镜排取异物保护套管装置的设计与应 用[J].临床合理用药杂志,2015,8(12):173-174.
[2] ASGE TECHNOLOGY COMMITTEE,TIERNEY WM,ADLER DG,et al.Overtube use in gastrointestinal endoscopy [J].Gastrointest Endosc, 2009,70(5):828-834.
[3] SEO YS,PARK JJ,KIM JH,et al.Removal of press-through-packs impacted in the upper esophagus using an overtube[J].World J Gastroenterol,2006,12(36):5909-5912.
[4] 石建华.引发食管异物并发症的危险因素[J].临床耳鼻咽喉头颈外科杂志,2004,18(12):758-759.
[5] SUNG SH,JEON SW,SON HS,et al.Factors predictive of risk for complications in patients with oesophageal foreign bodies [J].Dig Liver Dis, 2011,43(8):632-635.