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早期胃癌内镜下黏膜切除术后创面闭合中金属钛夹的应用
作者:方雅丽 
单位:西安市中心医院消化科  陕西 西安 710003 
关键词:胃肿瘤/外科学 内窥镜检查 胃黏膜/外科学  外科器械 伤口愈合 随机对照试验 随访研究 治疗结果 
DOI:R735.2;R730.56
出版年,卷(期):页码:2017,32(5):450-454
摘要:

目的 探讨金属钛夹在早期胃癌内镜下黏膜切除术(endoscopic mucosal resection,EMR)后创面闭合中的应用价值。方法 选取经胃镜检查发现的早期胃癌患者110例,采用随365bet娱乐官网网址机数字表法分为观察组与对照组各55例。观察组采用EMR联合金属钛夹闭合术治疗,对照组采用EMR治疗。门诊随访3个月,比较两组EMR术后创面闭合情况、临床指标(手术时间、住院时间、住院费用)与术后随访情况。结果 观察组EMR术后迟发性出血发生率低于对照组(0.0% vs 10.9%,P<0.05)。两组EMR术后迟发性穿孔发生率比较,差异无统计学意义(1.8% vs 7.3%,P>0.05)。两组手术时间、住院时间和住院费用比较,差异均无统计学意义(均P>0.05)。术后随访3个月两组患者均无腹痛和发热等不良反应,创面完整愈合。结论 金属钛夹在早期胃癌EMR后创面闭合中具有应用价值。

Objective To assess the application of titanium clamp for wound closure in endoscopic mucosal resection (EMR) of early gastric cancer. Methods One-hundred-and-ten patients with gastroscopy-identified early gastric cancer were randomly assigned in two groups with 55 cases in each group.EMR was performed in both groups,the titanium clamp was applied for wound closure in study group and not applied in control group.All patients were followed up for 3 months.Postoperative wound closure,operation time,length of hospital stay,hospitalization expenses and follow-up data were compared between the two groups. Results The incidence of postoperative late-onset bleeding was significantly lower in the study group than that in control group (0.0% vs 10.9%,P<0.05).No significant difference was detected for the incidence of postoperative late-onset perforation between two groups (1.8% vs 7.3%,P>0.05).Moreover,there were no significant differences in operation time,length of hospital stay,and hospitalization expenses between the two groups (all P>0.05).During the 3-month follow-up,no patient had abdominal pain,fever or other adverse effects.The wound healed completely for all patients. Conclusion Titanium clamp is of value in wound closure process of early gastric cancer after endoscopic mucosal resection.

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