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。

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。

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。

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。

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).

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.

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.

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.