摘要
[目的]探讨内镜下应急碎石器联合息肉勒除器治疗胃巨大结石的临床疗效及安全性分析.[方法]入选胃镜检查为胃巨大结石患者80例,按照随机数字法分为试验组、对照组,每组各40例,试验组予以内镜下应急碎石器联合息肉勒除器治疗,对照组予以胃石切割器治疗,比较2组间疗效、手术时间、临床完全缓解时间、住院时间、胃内残石率、术后视觉模拟评分(VAS)及并发症发生情况(出血、穿孔、贲门黏膜撕裂、肠梗阻).[结果]与对照组比较,试验组总有效率明显升高(100.0％:80.0％,x2=6.806,P=0.009),手术时间[(2.5±1.1)h:(3.1±1.2)h,t=-2.331,P=0.022]、临床完全缓解时间[(63.2±12.3)h:(84.1±10.4)h,t=-8.206,P＜0.001]、住院时间[(6.5±2.2)d:(9.2±2.8)d,t=-4.796,P＜0.001]及胃结石残存率(5.0％:22.5％,P=0.048)和 VAS 评分[(0.45±0.20)分:(1.25±0.32)分,t=-13.408,P＜0.001]明显下降;与对照组比较,试验组并发症总发生率明显下降(7.5％:27.5％,P=0.037).[结论]内镜下应急碎石器联合息肉勒除器治疗胃巨大结石优于胃石切割器,可作为治疗胃巨大结石患者的主要治疗方法,具有临床推广应用价值.
Abstract
[Objective]To investigate the clinical efficacy and safety of emergency stone crusher com-bined with polyp removal apparatus in the treatment of giant gastric calculi.[Methods]A total of 80 pa-tients with giant gastric calculi were selected,there were 42 males and 58 females with an age range of 32 to 90 years,with an average age of(43.6±6.8)years.They were divided into experimental group and control group according to random number method,with 40 cases in each group.The experimental group was trea-ted with emergency stone crusher combined with polyp removal apparatus,while the control group were treated with polyp removal apparatus.The therapeutic efficacy,operative time,clinical complete remission time,hospital stay,gastric residual stone rate,postoperative visual analog scale(VAS)and complications(bleeding,perforation,cardia mucosal tear,intestinal obstruction)were compared between the two groups.[Results]Compared with the control group,the total effective rate of experimental group was significantly increased(100.0％vs 80.0％,x2=6.806,P=0.009).Comparing with the control group,the operative time([2.5±1.1]h vs[3.1±1.2]h,t=-2.331,P=0.022),clinical complete remission time([63.2±12.3]h vs[84.1±10.4]h,t=-8.206,P＜0.001),hospital stay([6.5±2.2]d vs[9.2±2.8]d,t=-4.796,P＜0.001),gastric calculus survival rate(5.0％vs 22.5％,P=0.048)and VAS scores([0.45±0.20]scores vs[1.25±0.32]scores,t=-13.408,P＜0.001)in experimental group were significantly decreased(P＜0.05).Comparing with the control group,the total incidence of complications in the experimental group was significantly decreased(7.5％vs 27.5％,P=0.037).[Conclusion]Endoscopic emergency stone crusher combined with polypectomy is superior to polyp removal apparatus in the treatment of patients with giant gastric calculi,which can be used as the main treatment method for patients with giant gastric calculi and has clinical application value.
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