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目的探讨内镜下巨大消化道黏膜缺损联合缝合术的可行性和效果。方法通过双钳道治疗内镜利用尼龙圈和钛夹技术对消化道黏膜巨大缺损实施联合缝合术,观察其疗效。结果 8例巨大消化道黏膜缺损中6例为内镜下黏膜切除术后的黏膜缺损,1例为内镜下黏膜剥离术后直肠后壁穿孔,1例为食管癌术后胃壁气管瘘。采用直线式缝合4例,荷包式缝合4例。全部病例均获得满意缝合效果,黏膜缺损闭合,穿孔及瘘口封闭,无并发症发生。结论内镜下巨大黏膜缺损联合缝合术可行性强,能够有效地防止黏膜切除术后的迟发性出血和穿孔,并可促进黏膜缺损的愈合。
Objective To investigate the feasibility and effect of endoscopic mucosal defect combined with suturing. Methods Double clamp treatment of endoscopic nylon ring and titanium clip on the gastrointestinal mucosa giant defect joint suture surgery to observe its efficacy. Results Among the 8 cases of giant gastrointestinal mucosal defects, 6 cases were mucosal defects after endoscopic mucosal resection. One case was perforation of the posterior wall of rectum after endoscopic mucosal dissection and the other was gastric tube wall tracheal fistula after esophagectomy. Straight line suture in 4 cases, 4 cases of purse-suture. All cases were satisfactory suture effect, mucosal defects closed, perforation and fistula closed, no complications. Conclusion The combination of endoscopic mucosal debridement and suture is feasible and can effectively prevent delayed hemorrhage and perforation after mucosal resection and promote mucosal defect healing.