二氧化碳气体灌注在内镜黏膜下剥离术中的应用

目的评价二氧化碳气体灌注在内镜黏膜下剥离术（ESD）中的应用价值。方法选择2011年5月~2013年3月期间内镜黏膜下治疗的97例住院患者,其中男53例,女44例,随机分为空气灌注组41例和二氧化碳灌注组56例,统计一次性病灶完整切除率,记录手术时间、术后腹痛、腹胀例数、纵隔气肿或皮下气肿例数及气肿消退时间、患者住院时间。结果两组术后腹胀、腹痛发生率比较,差异有统计学意义（P〈0.05）;两组各种气肿消退天数比较,差异有统计学意义（P〈0.05）;血气的变化及术后住院时间无统计学意义（P〉0.05）。结论在ESD中,二氧化碳（CO2）气体灌注系统可减少临床症状及术中、术后并发症。

Application of carbon dioxide insufflations in endoscopic submucosal dissection

Objective To evaluate the value of carbon dioxide insufflation in the endoscopic submucosal dissection （ESD）. Methods A total of 97 patients accepted endocopic treatment from May 2011 to March 2013 were enrolled, male 53, female 44, air insufflation group of 41 cases and carbon dioxide insufflation group of 56 cases were randomly divided. The complete lesion resection rate was statistical analyzed; The operation time, abdominal pain and abdominal distention, incidence of mediastinal emphysema or subcutaneous emphysema, the extinctive time of emphysema and length of stay after-operation were recorded. Results There were statistically significant differences in the incidence abdominal pain and abdominal distention （P〈0.05）, there were statistically significant differences in the extinctive time of emphysema between the two groups （P〈0.05）, there were no statistically significant differences in the changes of blood air and the length of stay after-operation （P〉0.05）. Conclusion Carbon dioxide insufflation can reduce the clinical symptoms ancl intraoperative, postoperative complications in endoscopic submucosal dissection.