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 ›› 2024, Vol. 11 ›› Issue (01) : 28 -32. doi: 10.3877/cma.j.issn.2095-7157.2024.01.007

论著

便携式笔记本一次性大孔道内镜用于动物腹部战创伤内异物取出及止血可行性及安全性研究
宁波1, 左歆烨2, 关凯跃2, 赵晨怡3, 刘震宇3, 翟浩琪3, 令狐恩强1,†()   
  1. 1. 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；300071　天津，南开大学医学院
    3. 100853　北京，解放军总医院第一医学中心消化内科医学部；100853　北京，解放军医学院
  • 收稿日期:2023-10-08 出版日期:2024-02-15
  • 通信作者: 令狐恩强

Feasibility and safety of a portable laptop disposable large-channel gastroscope for foreign body removal and hemostasis of war abdominal trauma in animal models

Bo Ning1, Xinye Zuo2, Kaiyue Guan2, Chenyi Zhao3, Zhenyu Liu3, Haoqi Zhai3, Enqiang Linghu1,†()   

  1. 1. Department of Gastroenterology, The First Medical Centre of Chinese PLA General Hospital, Beijing 100853, China
    2. Department of Gastroenterology, The First Medical Centre of Chinese PLA General Hospital, Beijing 100853, China; Nankai University School of Medicine, Tianjin 300071, China
    3. Department of Gastroenterology, The First Medical Centre of Chinese PLA General Hospital, Beijing 100853, China; medical School of Chinese PLA, Beijing 100853, China
  • Received:2023-10-08 Published:2024-02-15
  • Corresponding author: Enqiang Linghu
全文 ( ) 下载PDF ( ) 导出引用
引用本文：

宁波, 左歆烨, 关凯跃, 赵晨怡, 刘震宇, 翟浩琪, 令狐恩强. 便携式笔记本一次性大孔道内镜用于动物腹部战创伤内异物取出及止血可行性及安全性研究[J]. 中华胃肠内镜电子杂志, 2024, 11(01): 28-32.

Bo Ning, Xinye Zuo, Kaiyue Guan, Chenyi Zhao, Zhenyu Liu, Haoqi Zhai, Enqiang Linghu. Feasibility and safety of a portable laptop disposable large-channel gastroscope for foreign body removal and hemostasis of war abdominal trauma in animal models[J]. Chinese Journal of Gastrointestinal Endoscopy(Electronic Edition), 2024, 11(01): 28-32.

目的

本研究应用便携式笔记本一次性大孔道内镜完成猪模拟战创伤模型内弹片的发现及取出；肝脏、胃肠道伤口造模及内镜下止血夹止血的有效性、安全性评估，探究在紧急野外腹部战创伤中替代腹腔镜技术实现超级微创内镜下异物取出及止血。

方法

利用巴马猪分别构建腹部弹片刺伤肝脏及消化道模型，选取气腹机构造气腹模型，便携式笔记本一次性大孔道内镜进行内镜下弹片取出及止血，选取止血夹进行止血，共选取3头巴马猪，分别进行重复实验，计算发现弹片时间、弹片取出成功率及失败率、弹片取出时间、肝脏及消化道止血成功率及失败率、止血所用时间、止血夹使用情况、内镜操作满意情况等。

结果

使用便携式笔记本一次性大孔道内镜系统进行异物发现及取出、内镜下止血各3次，均成功。便携式笔记本一次性大孔道内镜系统发现及取出弹片模型时间分别为(254.33±14.74)s、(174.00±12.20)s ；便携式笔记本一次性大孔道内镜在腹腔发现出血部位及止血时间分别为(194.00±10.74)s、(258.00±12.09)s；实验过程中，操作者对新型便携式笔记本内镜系统的操作过程满意，并且无不良事件和器械缺陷发生。

结论

便携式笔记本一次性大孔道内镜有用于紧急野外腹部战创伤所致腹腔内异物取出及腹腔内出血止血的潜力。

关键词: 便携式笔记本, 一次性, 大孔道内镜, 战创伤, 止血
Objective

In this study, we applied a portable laptop disposable large-channel endoscope to complete the discovery and removal of shrapnel in a porcine simulated war trauma model; liver and gastrointestinal wound modeling and endoscopic hemostatic clips for hemostasis were evaluated for effectiveness and safety, and we explored alternatives to laparoscopic techniques to achieve super-minimally invasive endoscopic foreign body removal and hemostasis in emergency field abdominal war trauma.

Methods

Bama pigs were used to construct abdominal shrapnel injury models of the liver and digestive tract, respectively; the pneumoperitoneum mechanism was selected to create a pneumoperitoneum model; a portable laptop disposable large-aperture endoscope was used to carry out endoscopic shrapnel removal and hemostasis, and hemostatic clips were used to carry out hemostasis; a total of three Bama pigs were selected to carry out the repeated experiments, and the time to discover the shrapnel, the success rate of shrapnel removal, the failure rate of the shrapnel removal, the time to remove the shrapnel, the success rate of hemostasis of the liver and the digestive tract and failure rate, time used for hemostasis, use of hemostatic clips, and satisfaction with endoscopic operation.

Result

Foreign body discovery and removal and endoscopic hemostasis were successfully performed three times each using a portable laptop disposable large-channel endoscopic system.Portable laptop disposable large-channel endoscopic system discovery and removal of the shrapnel model time were (254.33±14.74)s, (174.00±12.20)s; portable laptop disposable large- channel endoscopic discovery of the bleeding site in the abdominal cavity and the time of hemostasis were (194.00±10.74)s, (258.00±12.09)s, respectively; in the course of the experiments, the operators were satisfied with the procedure of the new portable laptop endoscopic system and there were no adverse events and device defects.

Conclusion

Portable laptop disposable large orifice endoscopy has the potential to be used for the removal of intra-abdominal foreign bodies due to emergency field abdominal combat trauma and the hemostasis of intra-abdominal hemorrhage.

Key words: Portable laptop gastroscope, Disposable gastroscope, Large-channel, Animal experiment, War trauma, Hemostasis
图1 使用便携式笔记本一次性大孔道胃镜进行腹部探查注：A：肝脏；B：胃；C：结肠
图2 便携式笔记本一次性大孔道胃镜进行弹片取出及止血注：A：发现弹片；B：取出弹片；C：出血；D：夹闭血管
表1 便携内镜弹片模型取出的情况
项目 发现弹片时间(s) 取出弹片时间(s)
便携内镜 254.33±14.74 174.00±12.20
表2 两组胃镜止血情况
项目 发现出血部位时间(s) 止血时间(s) 止血夹数量(枚)
便携内镜 194.00±10.74 258.00±12.09 1
[1]
Keene DD，Penn-Barwell JG，Wood PR，et al.Died of wounds：a mortality review[J]．J R Army Med Corps，2016，162 (5)：355-360.
[2]
Morrison JJ.Noncompressible Torso Hemorrhage[J]．Crit Care Clin, 2017, 33 (1)：37-54.
[3]
Holcomb JB.Transport Time and Preoperating Room Hemostatic Interventions Are Important: Improving Outcomes After Severe Truncal Injury[J]．Crit Care Med，2018，46 (3)：447-453.
[4]
Smyth LBC，Lee N，et al.WSES guidelines on blunt and penetrating bowel injury：diagnosis，investigations，and treatment[J]．World J Emerg Surg，2022, 17 (1): 13.
[5]
胥彬．上消化道穿孔采用腹腔镜联合胃镜行修补术治疗的临床分析[J]．心理月刊，2020, 15 (1)：218.
[6]
Penn-BJG，Roberts SA，et al.Improved survival in UK combat casualties from Iraq and Afghanistan: 2003-2012[J]．J Trauma Acute Care Surg，2015，78 (5)：1014-1020.
[7]
朱春平，刘肖肖，王智杰，等．新型便携式内镜系统用于上消化道内镜检查的实验研究[J]．中华消化内镜杂志，2020，37 (4) ：249-252.
[8]
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.
[9]
MacKenzie EJ，Rivara FP，Jurkovich GJ，et al.A national evaluation of the effect of trauma-center care on mortality[J]．N Engl J Med，2006，354 (4): 366-378.
[10]
Kreis DJ，Plasencia G，Augenstein D，et al.Preventable trauma deaths: Dade County，Florida[J]．J Trauma，1986，26 (7): 649-654.
[11]
Rignault DP.Abdominal trauma in war[J]．World J Surg，1992，16 (5): 940-946.
[12]
Holcomb JB，Jenkins D，Rhee P，et al.Damage control resuscitation: directly addressing the early coagulopathy of trauma[J]．J Trauma，2007, 62 (2): 307-310.
[13]
Tu FF，Advincula AP.Miniaturizing the laparoscope：current applications of micro- and minilaparoscopy[J]．Int J Gynaecol Obstet, 2008，100 (1): 94-98.
[14]
Oyo-Ita A，Chinnock P，Ikpeme IA.Surgical versus non-surgical management of abdominal injury[J]．Cochrane Database Syst Rev，2015, 11: Cd007383.
[15]
张宇，严加勇，顾良．新型腹腔镜技术的发展综述[J]．中国医疗器械杂志，2019，43(3)：183-187.
[16]
赵晨怡，宁波，董浩，等．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/CD]．中华胃肠内镜电子杂志，2023，10(1)：14-19.
[17]
la Chapelle CF，Swank HA，Wessels ME，et al.Trocar types in laparoscopy[J]. Cochrane Database Syst Rev, 2015, 12: Cd009814.
[18]
Rao PP，Bhagwat S．Single-incision laparoscopic surgery-current status and controversies[J]．J Minim Access Surg，2011，7(1): 6-16.
[1] 赵锦伟, 李晓军, 刘桂宇, 荣晓玲, 黄明利, 宋文静, 高广凌, 鞠昌军. 固定平台假体膝关节单髁置换术中止血带应用策略研究[J]. 中华关节外科杂志(电子版), 2024, 18(01): 39-47.
[2] 邓华梅, 袁札根, 曾德荣, 潘珊珊, 张葆青, 欧爱华, 曹学伟. 全膝关节置换术中气压止血带应用效果与影响因素分析[J]. 中华关节外科杂志(电子版), 2023, 17(06): 788-794.
[3] 黄超然, 郭开今, 吴继彬, 潘盛, 阮如昕, 庞勇, 张星晨, 郑欣. 止血带对全膝关节置换术后凝血状态的血栓弹力图评估[J]. 中华关节外科杂志(电子版), 2021, 15(04): 404-410.
[4] 储诚南, 丁威威, 杨超, 王新宇, 陈方, 王凯, 李维勤, 黎介寿. "三明治"法负压纱布填塞治疗严重腹部外伤合并出血的应用效果[J]. 中华危重症医学杂志(电子版), 2021, 14(06): 453-459.
[5] 王玉, 盛洁, 靳灵鸽, 蒋子文, 卢丹. 不同止血方式对腹腔镜下卵巢子宫内膜异位囊肿剥除术后卵巢储备功能的影响[J]. 中华妇幼临床医学杂志(电子版), 2021, 17(04): 420-424.
[6] 张霞, 钟炎平, 杨军杰, 毛静, 雷旭, 高岚, 雷飞飞, 谭华炳. 恙虫病致急性上消化道大出血、多器官功能衰竭经动脉栓塞止血抢救成功一例及文献复习[J]. 中华实验和临床感染病杂志(电子版), 2022, 16(02): 132-136.
[7] 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.
[8] 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.
[9] 陈慧超, 马珂珂, 宫丹丹, 王逸轩, 章蓓. 一次性切开根治术治疗肛周脓肿的Meta分析[J]. 中华结直肠疾病电子杂志, 2021, 10(04): 385-391.
[10] 范哲源, 颜京通, 孙嘉阳, 杨默笛, 高忠礼. 初次全膝关节置换术后压力绷带使用的研究进展[J]. 中华老年骨科与康复电子杂志, 2023, 09(04): 247-251.
[11] 徐如祥. 5G+智慧移动医疗技术与神经外科临床应用[J]. 中华脑科疾病与康复杂志(电子版), 2022, 12(01): 62-63.
[12] 高显奎, 赵太云, 陆兴俊, 张洪领, 房修罗, 闫碧春, 王胤, 王永翠, 刘苗苗, 冉若男. 内镜电凝止血与组织胶注射治疗上消化道溃疡伴出血的疗效观察[J]. 中华消化病与影像杂志(电子版), 2023, 13(06): 452-455.
[13] 蔡朝蓓, 李惠凯, 高飞, 韩珂, 令狐恩强. 消化道恶性肿瘤活动性出血不同内镜下止血方法的对比研究[J]. 中华胃肠内镜电子杂志, 2023, 10(03): 152-158.
[14] 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.
[15] 陈大庆. 严重创伤早期评估与处理[J]. 中华卫生应急电子杂志, 2023, 09(03): 192-192.
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