新型内镜扩张球囊在上消化道异物取出中作用研究

目的探讨一种新型内镜扩张球囊取出上消化道异物的安全性并评估其疗效。方法收集2018年7月至2019年3月收治于苏州大学附属第一医院经传统方法取出失败的10例上消化道异物患者的临床资料,其中食管异物8例,胃石2例,内镜扩张球囊辅助胃镜取出异物,观察操作成功率、异物取出所用时间、视野清晰度、黏膜损伤及并发症等情况。结果10例患者中,5例颈段异物顺利取出;3例胸段异物中,1例位于左锁骨下动脉附近(约5.0 mm),局部麻醉下取出;1例位于主动脉弓附近(约3.5 mm),静脉麻醉下取出;1例位于主动脉弓附近(约1.9 mm),在介入联合气管插管下取出;2例胃石,均为BillrothⅠ术后,1例通过取石网篮、圈套器顺利取出;另1例胃石排入小肠出现肠梗阻,行手术取出。所有患者均未造成二次损伤。结论内镜扩张球囊辅助胃镜取出上消化道异物具有较高的安全性,尤其对于常规方法无法取出的异物,避免了直接取出时的二次损伤。其操作简单、实用、并发症少,具有较好的临床推广价值。

Study on new endoscopic balloon dilation for removing foreign bodies in the upper gastrointestinal tract

Objective To observe the feasibility,safety and evaluate the therapeutic effect of new endoscopic balloon dilation for foreign bodies in upper gastrointestinal tract.Methods A retrospective analysis was peformed on data of 10 patients with foreign bodies in upper gastrointestinal tract,who underwent removed in the First Affiliated Hospital of Soochow University from July 2018 to March 2019.The success rate of operation,the time of take out,visual field clarity,mucosal injury and complications were observed.Results Among the ten patients,five cases with cervical esophageal foreign body was removed successful.Three cases of thoracic esophagus,one near left subclavian artery(about 5.0 mm),one near aortic arch(about 3.5 mm),last one near the aortic arch(about 1.9 mm).Two cases of gastric phytobezoar with underwent Billroth I operation.one case was removed through basket the other by surgery operatin.No secondary injury was caused in all patients.Conclusion The endoscopic balloon dilation is a safe,feasible and effective method for successful removal of foreign bodies in upper gastrointestinal tract.