切换至 "中华医学电子期刊资源库"
高级检索
中华胃肠内镜电子杂志

中华胃肠内镜电子杂志 ›› 2023, Vol. 10 ›› Issue (01) : 14 -19. doi: 10.3877/cma.j.issn.2095-7157.2023.01.007

论著

便携式一次性大孔道胃镜与常规胃镜在止血和内镜黏膜下剥离术中的应用对比：一项随机对照动物实验
赵晨怡1, 宁波2, 董浩1, 冯秀雪2, 李惠凯2, 柴宁莉2,†(), 令狐恩强2,†()   
  1. 1. 100853　北京，解放军医学院；100853　北京，解放军总医院第一医学中心消化内科医学部
    2. 100853　北京，解放军总医院第一医学中心消化内科医学部
  • 收稿日期:2023-01-20 出版日期:2023-02-15
  • 通信作者: 柴宁莉, 令狐恩强

Comparison of the application of a portable disposable large-channel gastroscope and a conventional reusable gastroscope in hemostasis and gastric endoscopic submucosal dissection (ESD): a randomized controlled animal experiment

Chenyi Zhao1, Bo Ning2, Hao Dong1, Xiuxue Feng2, Huikai Li2, Ningli Chai2,†(), Enqiang Linghu2,†()   

  1. 1. Medical School of Chinese PLA, Beijing 100853, China; Department of Gastroenterology, The First Medical Center of PLA General Hospital, Beijing 100853, China
    2. Department of Gastroenterology, The First Medical Center of PLA General Hospital, Beijing 100853, China
  • Received:2023-01-20 Published:2023-02-15
  • Corresponding author: Ningli Chai, Enqiang Linghu
全文 ( ) 下载PDF ( ) 导出引用
引用本文：

赵晨怡, 宁波, 董浩, 冯秀雪, 李惠凯, 柴宁莉, 令狐恩强. 便携式一次性大孔道胃镜与常规胃镜在止血和内镜黏膜下剥离术中的应用对比：一项随机对照动物实验[J]. 中华胃肠内镜电子杂志, 2023, 10(01): 14-19.

Chenyi Zhao, Bo Ning, Hao Dong, Xiuxue Feng, Huikai Li, Ningli Chai, Enqiang Linghu. Comparison of the application of a portable disposable large-channel gastroscope and a conventional reusable gastroscope in hemostasis and gastric endoscopic submucosal dissection (ESD): a randomized controlled animal experiment[J]. Chinese Journal of Gastrointestinal Endoscopy(Electronic Edition), 2023, 10(01): 14-19.

目的

本研究将便携式一次性大孔道胃镜与常规胃镜在清创止血及内镜黏膜下剥离术(ESD)上的有效性、安全性做了对比。

方法

使用家兔耳朵构建胃腔出血模型，便携式一次性大孔道胃镜为实验组，常规胃镜为对照组，对出血处进行清创并通过喷洒止血粉达到止血目的，对两组胃镜的整体操作时间、止血粉用量、止血成功率以及送粉管堵塞次数进行比较。使用两组胃镜对巴马小型猪进行ESD治疗，实验由经验丰富的内镜医师参与完成。将两组胃镜的ESD总时间、完整切除率、穿孔率、器械故障率以及内镜系统使用满意度进行比较，并将两组胃镜在术中所采集的图片进行评估打分。

结果

两组胃镜均成功完成止血。实验组的止血粉用量(2.54±0.97)g与对照组的用量(2.25±0.79)g，差异无统计学意义。对照组的送粉管发生过1次堵塞，而实验组的送粉管未发生过阻塞的情况。整体操作时间上，实验组时间(86.62±13.68)s，明显短于对照组(101.75±17.14)s，P值为0.004。两组胃镜各进行了16次ESD操作，两组病灶的完整切除率均为100%，实验组ESD总时间为(19.22±9.50)min，对照组的ESD总时间为(17.72±5.15)min，P值为0.985，差异无统计学意义。两组均无穿孔等并发症发生，两组器械也均未发生故障。实验组胃镜使用后满意度评价中，有15次为非常满意，1次为基本满意，对照组16次均为非常满意，P值为0.500，差异无统计学意义。两组胃镜所采集图片的评分相比差异也无统计学意义。

结论

便携式一次性大孔道内镜可以安全、有效的进行内镜下治疗，在减少医源性感染、突破内镜使用的场所限制上具有重要意义。

关键词: 便携式, 一次性, 大孔道, 胃镜, 动物实验
Objective

In this study, we compared the effectiveness and safety of the portable disposable large-channel endoscope and a conventional gastroscope in hemostasis and endoscopic submucosal dissection (ESD).

Methods

Rabbits were treated with debridement and hemostasis after general anesthesia. After constructing the model of gastrorrhagia, the endoscopic surgeons randomly selected a gastroscope to debridement the bleeding site and spray hemostatic powder to achieve hemostasis. We will compare the overall operation time, the amount of hemostatic powder, the success rate of hemostasis and the times of plugging of the powder delivery tube between the two groups. Overall operation time, the amount of hemostatic powder, the success rate of hemostasis and the times of plugging of the powder delivery tube were compared between the 2 types of endoscopes. Bama pigs would receive ESD treatment after general anesthesia. The experiment was completed by experienced endoscopic physicians. Total duration of ESD, success rate of en bloc resection, perforation rate, device failure rate, satisfaction with the use of endoscope system and picture rating were compared between the 2 types of endoscopes.

Result

Both groups successfully completed hemostasis. There was no difference between the dosage of hemostatic powder in the experimental group (2.54±0.97) g and that in the control group (2.25±0.79) g. The powder delivery tube in the control group was blocked once. In the overall operation time, the experimental group (86.62±13.68) s was significantly shorter than that in the control group (101.75±17.14) s, with P value=0.004. Both groups completed 16 ESDs. There were no significant differences between the total duration of ESD in the experimental group (19.22±9.50) min and that in the control group (17.72±5.15) min, with P value =0.985. There were no differences in success rate of en bloc resection and picture rating between the 2 types of gastroscopes. Neither of the gastroscopes caused perforation during ESD. There was no failure of the instruments in both groups. The satisfactions evaluation of two groups were basically satisfactory and above.

Conclusion

The portable disposable large-channel digestive endoscope could perform gastroscopy and treatment effectively, which is of great significance in reducing infection and breaking the restriction of the use of endoscope.

Key words: Portable gastroscope, Disposable gastroscope, Large-channel, Animal experiment
图1 胃腔出血模型
图2 使用便携式一次性大孔道胃镜完成ESD 注：A:使用便携式一次性大孔道胃镜进行ESD操作；B:对病变进行标记；C:在病变周围进行黏膜下注射；D:拍照标记将病变边缘切开；E:逐步剥离病变；F:将病变完整剥离
表1 两组胃镜对胃腔出血模型的止血治疗情况
项目 实验组 对照组 P值
止血粉用量(g) 2.54±0.97 2.25±0.79 0.445
送粉管堵塞次数 0 1 －
止血成功率(n/n，%) 16/16(100) 16/16(100) －
整体操作时间(s) 86.62±13.68 101.75±17.14 0.004
表2 两组胃镜ESD操作对比情况
项目 实验组(n＝16) 对照组(n＝16) P值
ESD总时间(min) 19.22±9.50 17.72±5.15 0.985
完整切除率(n/n，%) (16/16)100 (16/16)100 －
穿孔率(%) 0 0 －
器械故障率(%) 0 0 －
表3 内镜系统使用满意度评价(次)
分组 非常满意 基本满意 不满意 P值
实验组 15 1 0 0.500
对照组 16 0 0  
表4 术中采集图片评分情况(次)
图片总分 实验组 对照组 P值
0 0 0 0.982
1 0 0  
2 1 0  
3 3 4  
4 60 60  
[1]
杨辉，胡凯，夏建松，等．便携式电子内窥镜的开发及临床应用[J].中国医疗器械杂志，2021，45(2)：153-158.
[2]
Hervé RC，Keevil CW.Persistent residual contamination in endoscope channels：a fluorescence epimicroscopy study[J].Endoscopy，2016，48 (7): 609-616.
[3]
Ellrichmann M，Eickhoff A．Single-use products in endoscopy-from consumables to single-use scopes[J].Gastroenterologe，2022，17(1): 15-21.
[4]
Rutter MD，Brookes M，Lee TJ，et al.Impact of the COVID-19 pandemic on UK endoscopic activity and cancer detection：a National Endoscopy Database Analysis[J]. Gut，2021，70(3)：537-543.
[5]
Liang Z，Zhou G，Li Y，et al.Evaluation of a new developed disposable and portable bronchoscopy system[J].BMC Pulm Med，2022, 22(1): 136-148.
[6]
Trindade AJ，Copland A，Bhatt A，et al.Single-use duodenoscopes and duodenoscopes with disposable end caps[J].Gastrointest Endosc，2021，93(5)：997-1005.
[7]
Patterson K，Yap LC，Elamin M，et al.Evaluation of a new disposable flexible ureterorenoscope and comparison to an established disposable flexible ureterorenoscope：a prospective, observational study[J]. Int Urol Nephrol，2021，53(5)：875-881.
[8]
Ryu K, Jang S. Single Use (Disposable) Duodenoscope: Recent Development and Future[J]. Clin Endosc，2022，55(2)：191-196.
[9]
张婷，朱春平，邹文斌，等．新型便携式内镜系统应用于上消化道疾病检查的多中心临床研究[J].中华消化内镜杂志，2022，39(2): 96-102.
[10]
Luo X，Ji M，Zhang S，et al.Disposable versus reusable gastroscopes：a prospective randomized noninferiority trial[J]. Gastrointest Endosc，2022，96(2)：250-261.
[1] 马骏, 王月香, 罗渝昆, 高菡静, 孟祥宇, 费翔, 肖静, 李文. 细微血流成像对肾挫裂伤诊断价值的动物实验研究[J]. 中华医学超声杂志（电子版）, 2022, 19(09): 994-998.
[2] 陈樱, 陈艳莉. 高龄孕妇心率变异性原因及围产结局分析[J]. 中华妇幼临床医学杂志(电子版), 2023, 19(03): 295-301.
[3] 沈纵, 魏晨如, 朱邦晖, 包郁露, 伍国胜, 孙瑜. 间充质干细胞治疗吸入性损伤的动物实验研究进展[J]. 中华损伤与修复杂志(电子版), 2023, 18(02): 180-183.
[4] 张杰, 吕远, 孙亮, 苏惠, 谢惠, 袁强, 王昕, 杜峻峰, 金鹏, 陈纲. 腹腔镜-胃镜联合手术处理困难部位胃间质瘤的临床分析[J]. 中华普外科手术学杂志(电子版), 2023, 17(03): 284-286.
[5] 张磊, 米洋, 王昌喜, 李曜行, 王小东, 牛旭东, 王靖宇. 一次性输尿管软镜通路鞘两种置入深度的临床研究[J]. 中华腔镜泌尿外科杂志(电子版), 2023, 17(05): 486-489,494.
[6] 林剑峰, 叶志彬, 梁福律, 范先明, 胡力仁, 涂建平, 郭昭建. 一次性输尿管软镜在具有内镜损害高危因素上尿路结石手术中的初步应用[J]. 中华腔镜泌尿外科杂志(电子版), 2022, 16(03): 231-234.
[7] 于茜, 周建辉, 谢大洋, 杨巧巧, 赵小淋, 王宏. 人工肾的研究进展[J]. 中华肾病研究电子杂志, 2022, 11(04): 224-230.
[8] 黄泽辉, 梁杰贤, 曾伟. 右美托咪定联合艾司氯胺酮在小儿无痛胃镜检查中的应用研究[J]. 中华消化病与影像杂志(电子版), 2023, 13(06): 510-513.
[9] 刘梦真. 心理疏导对初次行电子胃镜检查患者的情绪及成功率的影响[J]. 中华消化病与影像杂志(电子版), 2022, 12(05): 317-319.
[10] 李微, 陈晓莉, 蔡仁颂, 朱莉, 闾素婷, 邢小丽. 白光胃镜下胃黏膜形态变化对幽门螺杆菌感染的诊断价值分析[J]. 中华临床医师杂志(电子版), 2022, 16(02): 152-156.
[11] 王擎, 王冠峰, 陈星. 胃食管阀瓣的Hill分级在胃食管反流病中的应用价值[J]. 中华胃肠内镜电子杂志, 2023, 10(02): 125-130.
[12] 汪颖, 李泉, 李沛霖, 薛立新, 吴璇, 刘宝胤. 减重代谢手术前后规范化胃镜检查的分析研究[J]. 中华胃肠内镜电子杂志, 2022, 09(02): 91-94.
[13] 陈礼鹏, 程启闰, 朱为民, 季木西, 郑培奋. 地佐辛联合耳穴压豆对老年患者无痛胃镜下黏膜切除术后疼痛的缓解效果[J]. 中华老年病研究电子杂志, 2022, 09(02): 35-39.
[14] 喇宏玲, 李育耕, 阿里木江·司马义, 徐桂萍, 苏涛. 右美托咪定复合舒芬太尼应用于肥胖患者无痛胃镜检查清醒镇静的效果[J]. 中华胃食管反流病电子杂志, 2023, 10(02): 77-81.
[15] 王志, 麦麦提艾力, 李慧灵, 艾克拜尔, 李义亮, 邓秀丽, 克力木·阿不都热依木. 腹腔镜联合胃镜治疗食管裂孔疝合并膈上食管憩室的临床疗效[J]. 中华胃食管反流病电子杂志, 2022, 09(04): 196-198.
阅读次数
全文


摘要

版权所有 中华医学会 中华医学电子音像出版社有限责任公司  京ICP备14006079号-1  网络出版服务许可证：(署)网出证(京)字第075号