电子胃镜介导治疗胃石症的方法探讨

目的探讨电子胃镜介导下选择不同的器械治疗胃石的方法、效果及其安全性。方法在该院接受电子胃镜检查的34218人次中检出胃石症71例（检出率为0．2％），根据具体情况选择适当的器械，包括五爪钳、鼠齿钳、异物网篮和圈套器等，在电子胃镜下进行治疗，观察其疗效。结果碎石成功率为100％，平均治疗时间36min。63．4％用五爪钳直接破碎。11．3％直接用网篮或圈套器拖出，23．9％用异物钳与圈套器配合破碎或拖出，其中催吐后再次胃镜下破碎7例（9．9％），次日再次破碎4例（5．6％）。术中胃黏膜因轻微机械性损伤有少量渗血，1例并发肠梗阻，无其他明显并发症。结论电子胃镜下应用适当的器械碎石或取石是治疗胃石症的最佳方法，操作简便，安全有效，值得临床推广应用。

Therapeutic methods of the bzoar with different appliance through the electronic gastroscope

Objective To investigate the therapeutic methods,effect and safety in removing the bezoars with different appliance through the electronic gastroscope. Methods 71 cases of the bezoars,which were detected in 34218 cases with the electronic gastroscope in our hospital,were treated with suitable methods through the electronic gastroscope with appliances,including the penta-claw grasping forceps,rat-tooth grasping forceps,and grasping basket and snare. The therapeutic effect was observed for one week. Results The detection rate of bezoars was 0.2%. All bezoars were broken into pieces or removed out,and the mean time of treatment was 36 minutes. 63.4% of them quassated directly by penta-claw grasping forceps,11.3% pulled out directly by grasping basket and snare,23.9% treated in turn by grasping forceps and snare,7 cases (9.9%) treated again after emetic,and 4 cases (5.6%) treated in the next day. There were some lightly scrape and small amounts of errhysis during the operation,but no other serious complications except one case of bowel obstruction. Conclusion Removing bezoars through the electronic gastroscope by suitable appliances and methods was one of the best,safest,easiest and most effective manipulation and worth generalizing and utilizing clinically.