食管尖锐异物取出过程中透明帽的应用效果和经验

目的探讨透明帽在食管尖锐异物取出术中的有效性及安全性。方法回顾分析2015年1月至2017年1月我院内镜中心取出的食管尖锐异物124例。男性76例,女性48例。年龄16~82岁。无透明帽辅助胃镜取出组54例,透明帽辅助胃镜下取出组70例。比较两种治疗的视野清晰率,异物取出时间、成功率、粘膜损伤发生率,出血及穿孔等并发症发生率。结果透明帽辅助组患者异物取出平均时间为(234.14±67.38)秒,无透明帽辅助者取出平均时间为(337.11±116.61)秒,前者比后者时间明显缩短,具有统计学差异P0.05)。透明帽辅助组取出成功率及视野清晰率优于无透明帽辅助组,具有统计学差异(P0.05),透明帽辅助组患者粘膜损伤发生率及并发症发生率均低于无透明帽辅助组,具有统计学差异(P0.05)。结论应用透明帽辅助取食管尖锐异物可明显缩短手术时间,提高视野清晰可及成功率,降低粘膜损伤率,减少并发症发生率,是一直安全有效的方法,具有良好的临床价值。

Application and experience of transparent cap-assisted removal of sharp foreign bodies impacted in the esophagus during endoscopy

Objective To explore the efficacy and safety of transparent cap in sharp foreign body removal and summarize experience. Methods 124 cases of esophageal sharp foreign body were retrospectively analyzed in Endoscopic Center of our hospital from January 2015 to January 2017. Of 124 cases，76 were males and 48 females，aged 16- 82 years. All patients wereimplemented endoscopic removal of sharp foreign bodies impacted in the esophagus，in which 70 cases were performed operation by transparent cap- assisted procedure（transparent cap group），54 cases were under non- transparent cap assisted group. The visual field clarity，time of foreign body removal，success rate，mucosal injury rate， complications of bleeding and perforation were recorded and analyzed. Results The mean time of transparent cap group was 234.14 ± 67.38 s，and 337.11 ± 116.61 s of the non- transparent group（P<0.05）. The success rate and visual field clarity rate of the transparent cap group were better than those of the non-transparent cap group，and the difference was statistically significant（P<0.05）. The rate of mucosal injury and the incidence of complications in transparent cap assisted group were significantly lower than those in the non-transparent caps group，with statistical difference（P<0.05）. Conclusion The procedure of transparent cap-assisted endoscopy for removal of esophageal sharp foreign bodies showed shorten the operation time，had higher success rate and visual field clarity，reduce the mucosal damage and complications.