经内镜双腔导管注入生物蛋白胶预防胃肠穿透性疾病的研究

目的经胃肠镜微创治疗存在出血穿孔的并发症，在一定程度上局限了内镜治疗的应用，为提高内镜微创治疗的安全性，避免和减少并发症，在临床实践中努力寻找对策，为内镜治疗后的预防性治疗进行探索。方法经内镜双腔导管注入生物蛋白胶防治胃肠穿透性疾病，经内镜下双腔导管注入生物蛋白胶快速修复溃疡面，内镜下切除术后创面预防性治疗。我院胃镜或肠镜进行内镜下治疗47例，其中胃镜下38例，肠镜下9例。十二指肠球部巨大穿透性溃疡19例，边缘整齐的胃良性溃疡5例，食管气管凑2例，广基胃肠息肉内镜下切除创面15例，食管黏膜肌层平滑肌瘤内镜下切除创面3例，EMR黏膜切除术后创面预防性治疗3例，每两周复查一次内镜，测量创面直径。结果经内镜双腔导管注入生物蛋白胶治疗穿透性溃疡预防穿孔，修复比单纯内科治疗愈合迅速，创面对合整齐；能够修复已经穿孔的清洁的小食管气管瘘。与常规内镜检查和内镜下单纯切除法相比，对于较大和较深内镜创面，经内镜双腔导管注入生物蛋白胶，出血穿孔几率显著减少，几乎为零。结论选择经内镜双腔导管注入生物蛋白胶防治胃肠穿透性疾病新方法，使胃肠镜微创手术安全性显著提高。

Investigation of preventing gaslrointestinal penetrativity disease with influxing bio~otein gel through double channeicatheter of endoscope

AIM Micro wound therapy with gastrcenterological endoscope will generate complication of bleed and perforate, it limited the application of endoscopic in some degrees, to elevate the safe of endoscopic therapy and avoid or reduce complication, we should make efforts to look for strategies in clinical practice and make beneficial explorations of prophylactic treatment after therapeutic endoscope. METHODS gastrointestinal disease was prevented and cured with influxing bioprotein gel through double channel catheter of endoscope, anabrosis were quickly recovered with influxing bioprotein gel through double channel catheter of endoscope, and prophylactic treatment of raw surface were made after exairesis with endoscope. 47 cases were therapied with gastroscope and enteroscope, including 38 cases with the gastroscope, 9 cases with enteroscope. 19 cases were ulcer penetrans of duodenal bulb, 5 cases were innocence ulcer of stomach with concinnous borderline, 2 case were esophagus tracheal fistula, 15 case were ectomizing raw surface of wide base gastrointestinal polyp with endosdepe, 3 cases were ectomizing raw surface after EMR mucosectomy, diameter of raw surface were rechecked with endoscope fortnightly interval. RESULT Penetrating ulcer concreted more quickly and raw surface annealed more regularitily with influxing bioprotein gel through double channel catheter of endoscope than merely medical compare with convention endoscopy and simple ablation under endoscope, The probability of bleed and perforate was reduced significantly and almost has none. CONCLUSION New approach of preventing and curing gastrcenteric penetrativity disease with influxing bioprotein gel through double channel catheter of endoscope significantly increase safety of gastroenterological endoscope operation.