黏膜下注射生理盐水在食管、胃、结肠无蒂息肉内镜治疗中的应用

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目的探讨黏膜下注射生理盐水与肾上腺素生理盐水,在食管、胃、结肠无蒂息肉内镜治疗中的疗效和安全性方面的差异。方法在内镜下治疗食管、胃、结肠无蒂息肉时,采用随机对照设计,设试验组和对照组,分别使用生理盐水和肾上腺素生理盐水(1∶10 000)进行黏膜下注射,随后用高频电刀切除病灶,在疗效和并发症方面进行对比研究。结果黏膜下注射生理盐水和肾上腺素生理盐水都可以有效地减少创面出血,且治疗效果确切,试验组和对照组无出血率分别为89.39%和92.31%,组间比较差异无统计学意义(P>0.05),对照组黏膜下注射后有8例心率增快、5例血压升高,两组比较差异有统计学意义(P<0.05)。结论在食管、胃、结肠无蒂息肉的内镜治疗中单纯使用生理盐水作为黏膜下注射液,既能有效预防穿孔,又能减少出血,尚可避免肾上腺素的并发症,可以取代肾上腺素生理盐水。 Objective To investigate the efficacy and safety of submucosal injection of saline and epinephrine saline in endoscopic treatment of esophageal, gastric and colon pedicleless polyps. Methods In the endoscopic treatment of esophageal, gastric and colon pedunculated polyps, a randomized controlled trial was designed. The experimental group and the control group were injected subcutaneously with normal saline and epinephrine normal saline (1:10 000) High-frequency electric knife removal of lesions in the efficacy and complications of comparative studies. Results Submucosal injection of saline and epinephrine saline can effectively reduce the wound bleeding, and the treatment effect is exact, the experimental group and the control group were no bleeding rate was 89.39% and 92.31%, no significant difference between groups was statistically significant (P > 0.05). After submucosal injection in control group, the heart rate of 8 patients increased faster and the blood pressure increased in 5 patients. The difference between the two groups was statistically significant (P <0.05). Conclusion In the endoscopic treatment of esophageal, gastric and pedunculated polyps, simply using saline as submucosal injection can not only effectively prevent perforation but also reduce bleeding, while avoiding the complications of epinephrine, which can replace epinephrine physiology brine.
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