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目的:探讨内镜直视下钬激光碎石术治疗胃结石的策略和临床价值.方法:回顾性分析2009-01/2014-12华中科技大学同济医学院附属同济医院37例经胃镜检查诊断发现胃或十二指肠结石患者的病例资料.对单纯内科药物或可乐治疗、采取圈套器、异物钳碎石术治疗以及钬激光碎石术治疗胃石症的临床疗效进行总结分析,结合手术操作的时间及设备的耗损进行对比分析,比较各种方法的优点及缺点.结果:37例患者中13例患者采用单纯药物或可乐治疗,11例患者随访胃镜显示结石消失或减小,临床症状明显改善,2例失败转为手术治疗;17例患者采用圈套器或异物钳碎石治疗,16例患者痊愈或明显缓解症状,1例发生幽门梗阻转外科继续治疗,平均耗时92.35min±44.80 min,平均损耗器械1.86个±0.62个;采用钬激光碎石术治疗7例,结石直径较大且多位多发,术后2 wk复查胃结石均明显消失,操作平均耗时22.15 min±10.35 min,平均者损耗器械0.44个±0.40个.结论:钬激光碎石术是一种可靠安全的治疗胃结石的手段,尤其对多发、质地较硬、体积较大的胃结石可以迅速有效地解除患者的痛苦.
Objective: To investigate the strategy and clinical value of holmium laser lithotripsy in the treatment of gastric stones under endoscopy.Methods: A retrospective analysis of 37 cases of Tongji Hospital affiliated to Tongji Medical College of Huazhong University of Science and Technology from January 2009 to December 2014 was retrospectively analyzed Gastric or duodenal calculi in patients with simple medical or cola treatment, the use of snare, foreign body forceps lithotripsy and holmium laser lithotripsy treatment of the clinical efficacy of gastroscopy summary analysis, combined with surgical procedures Time and equipment consumption were compared, and the advantages and disadvantages of various methods were compared.Results: Thirteen patients in 37 patients were treated with simple drugs or coke, 11 patients were followed up gastroscope showed that the stones disappeared or reduced, and the clinical symptoms were obvious 17 cases were treated with snare or foreign body caliper grafting, 16 cases were cured or significantly relieved symptoms, 1 case of pyloric obstruction was transferred to the surgical treatment, the average time-consuming 92.35min ± 44.80 min , The average loss of equipment 1.86 ± 0.62; using holmium laser lithotripsy in 7 cases, the larger the diameter of stones and multiple multiple postoperative 2wk review of gastric stones were significantly disappeared, the operating level Which took 22.15 min ± 10.35 min and averaged 0.44 ± 0.40 devices.Conclusion: Holmium laser lithotripsy is a reliable and safe method for the treatment of gastric stones, especially for multiple, hard texture, large volume stomach Stones can quickly and effectively relieve a patient’s pain.