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电子胃镜与硬质食管镜取出食管异物系统评价与Meta分析
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作者 马继龙 金大成 +3 位作者 王兵 柏启州 于珺 苟云久 《中国耳鼻咽喉头颈外科》 CSCD 2019年第5期266-271,共6页
目的硬质食管镜及电子胃镜是目前食管异物的主流治疗方式,但两者的选择及优劣尚无准确定论,本文用系统评价的方法对两种术式进行比较,对其优劣进行讨论。方法计算机检索PubMed、Embase、Cochrane、知网、万方和维普等数据库。按照预先... 目的硬质食管镜及电子胃镜是目前食管异物的主流治疗方式,但两者的选择及优劣尚无准确定论,本文用系统评价的方法对两种术式进行比较,对其优劣进行讨论。方法计算机检索PubMed、Embase、Cochrane、知网、万方和维普等数据库。按照预先设定的检索词进行检索,由两位研究者独立阅读检出文献题目和摘要,根据纳入标准筛选文献、评估纳入文献质量及提取资料,采用Cochrane协作网推荐的RevMan 5.3软件进行Meta分析。结果纳入的9个研究共包含样本1952例,其中875例行硬质食管镜,1077例行电子胃镜。其中上段食管异物患者1078例,中段食管异物患者188例,下段食管异物患者204例。纳入人群平均年龄36.4岁。硬质食管镜与电子胃镜取食管异物成功率相同[OR=1.55,95%CI(0.95,2.53),P=0.08],食管异物并发症发生率相同[OR=1.53,95%CI(1.01,2.32),P=0.05],食管异物穿孔发生率相同[OR=2.45,95%CI(0.75,8.06),P=0.14],硬质食管镜组除穿孔外的并发症发生率较电子胃镜组高[OR=2.48,95%CI(1.27,4.85),P=0.008],手术时间相同[OR=6.29,95%CI(-1.72,14.30),P=0.12]。结论在食管异物的治疗中两种方法是互补的,增加取出异物的成功率,减少相关并发症。 展开更多
关键词 食管 异物 META分析 硬质食管镜 电子胃镜
内镜中心应用FOCUS-PDCA模式提高软式内镜消毒质量的研究 被引量:12
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作者 杨建娣 朱林贞 +1 位作者 杨超娟 徐虹 《中华医院感染学杂志》 CSCD 北大核心 2017年第18期4252-4254,4302共4页
目的查找内镜清洗消毒过程中存在的问题,制定有效的策略,持续提高内镜消毒质量。方法应用FOCUS-PDCA程序,查找影响内镜消毒失败的各个环节,进行分析整改、培训考核。改进前(2014年11月-2015年3月)检测内镜24件,改进中(2015年4月-2016... 目的查找内镜清洗消毒过程中存在的问题,制定有效的策略,持续提高内镜消毒质量。方法应用FOCUS-PDCA程序,查找影响内镜消毒失败的各个环节,进行分析整改、培训考核。改进前(2014年11月-2015年3月)检测内镜24件,改进中(2015年4月-2016年4月)检测内镜120件,改进后(2016年5月-2017年6月)检测内镜350件;应用倾注培养加滤膜接种的方法检测内镜消毒后菌落总数,比较不同阶段内镜消毒合格率以及护士、清洗工人知识掌握情况。结果内镜菌落总数的合格率由改进前的75.0%、改进中的86.7%,提高到改进后的98.6%(χ^2=36.673,P〈0.01),呈线性趋势;胃镜、肠镜和支气管镜的检测合格率均升高(χ^2=7.250,P=0.019;χ^2=11.012,P=0.003;P〈0.01);机器清洗的胃镜菌落总数合格率由改进前的66.7%提高到100.0%(χ^2=7.030,P=0.048);手工清洗的肠镜合格率由50.0%提高到100.0%(χ^218.096,P〈0.01);手工清洗的支气管镜合格率由77.3%提高到99.4%(P〈0.01);护士与工人的知识技能评分也由91.2分提高到96分(t=8.232,P=0.001)。结论利用FOCUS-PDCA模式可对软式内镜清洗、消毒各环节及时进行管理和改进,规范了内镜洗消流程,持续提高了内镜消毒质量。 展开更多
关键词 FOCUS-PDCA模式 软式内镜 清洗 消毒
Usefulness of the Hook knife in flexible endoscopic myotomy for Zenker’s diverticulum 预览
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作者 Olivier Rouquette Armando Abergel +1 位作者 Aurélien Mulliez Laurent Poincloux 《世界胃肠内镜杂志:英文版(电子版)》 2017年第8期411-416,共6页
AIM To investigate the outcome of flexible endoscopic myotomy performed with the Hook knife in patients with symptomatic Zenker’s diverticulum(ZD).METHODS All consecutive patients treated for ZD at our institution be... AIM To investigate the outcome of flexible endoscopic myotomy performed with the Hook knife in patients with symptomatic Zenker’s diverticulum(ZD).METHODS All consecutive patients treated for ZD at our institution between 7/2012 and 12/2016 were included.The flexible endoscopic soft diverticuloscope-assisted technique with endoclips placement and Hook knife myotomy were performed in all patients.Here we report a retrospective review of prospectively collected data.Demographics,dysphagia score(Dakkak and Bennett),associated symptoms and adverse events were collected pre-procedure,at 2 and 6 mo post-procedure,and at the end of the follow-up period.Clinical success was defined as at least 1-point improvement in dysphagia score and a residual dysphagia score≤1,with no need for reintervention.Dysphagia scores were compared before treatment and at end-of-follow-up using the Wilcoxon test.RESULTS Twenty-four patients were included.Mean size of ZD was 3.0 cm(range 2-8 cm).Mean number of sessions was 1.17/patient(range 1-3 sessions).Overall clinical success was 91.7%.Two adverse events(8.3%) occurred,and both were managed conservatively.No bleeding or perforation was reported.Mild pain was reported by 9 patients(37.5%).Median hospital stay was 1 d(range 1-6).Median follow-up was 19.5 mo(range 6-53).Mean ± SD dysphagia score was 2.25±0.89 before treatment and decreased to 0.41 ± 0.92 at end-of-follow-up(P<0.001).Regurgitation and cough dropped from 91.7% and 50% to 12.5% and 0% at the end of follow-up,respectively.Recurrence was observed in 3 patients,and all 3 were symptom-free after one more session.CONCLUSION The Hook knife,used in the soft diverticuloscope-assisted technique setting,is efficient and safe for treatment of ZD. 展开更多
关键词 Zenkers 憩室 灵活内视镜检查法
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邻苯二甲醛和酸性氧化电位水消毒软式内镜效果比较 被引量:3
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作者 葛冬梅 《中国消毒学杂志》 北大核心 2017年第10期922-924,共3页
目的比较邻苯二甲醛(OPA)与酸性氧化电位水(AEOW)对软式内镜的消毒效果。方法采用现场消毒实验方法,观察两种消毒剂对消化内镜消毒效果,并对使用中相关参数作出评价。结果用浓度为5 500 mg/L的OPA消毒,胃镜表面消毒全部合格,内腔消... 目的比较邻苯二甲醛(OPA)与酸性氧化电位水(AEOW)对软式内镜的消毒效果。方法采用现场消毒实验方法,观察两种消毒剂对消化内镜消毒效果,并对使用中相关参数作出评价。结果用浓度为5 500 mg/L的OPA消毒,胃镜表面消毒全部合格,内腔消毒合格率为98.57%;对肠镜表面消毒,其表面与内腔消毒效果合格率分别为100.00%和93.13%。用AEOW分别对胃镜和肠镜消毒,其表面和内腔消毒效果合格率均低于OPA组。结论邻苯二甲醛消毒内镜的效果好于酸性氧化电位水,内镜的内腔比内镜表面消毒更困难。 展开更多
关键词 软式内镜 邻苯二甲醛 酸性氧化电位水 消毒效果
Western view of the management of gastroesophageal foreign bodies 预览 被引量:1
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作者 Aurora Burgos Luis Rábago Paloma Triana 《世界胃肠内镜杂志:英文版(电子版)》 2016年第9期378-384,共7页
The best modality for foreign body removal has been the subject of much controversy over the years. We have read with great interest the recent article by Souza Aguiar Municipal Hospital, Rio de Janeiro, Brazil,descri... The best modality for foreign body removal has been the subject of much controversy over the years. We have read with great interest the recent article by Souza Aguiar Municipal Hospital, Rio de Janeiro, Brazil,describing their experience with the management of esophageal foreign bodies in children. Non-endoscopic methods of removing foreign bodies (such as a Foley catheter guided or not by fluoroscopy) have been successfully used at this center. These methods could be an attractive option because of the following advantages: Shorter hospitalization time; easy to perform; no need for anesthesia; avoids esophagoscopy;and lower costs. However, the complications of these procedures can be severe and potentially fatal if not performed correctly, such as bronchoaspiration,perforation, and acute airway obstruction. In addition, it has some disadvantages, such as the inability to directly view the esophagus and the inability to always retrieve foreign bodies. Therefore, in Western countries clinical practice usually recommends endoscopic removal of foreign bodies under direct vision and with airway protection whenever possible. 展开更多
关键词 Foreign BODIES Children Foley CATHETER Flexible ENDOSCOPY
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泌尿外科手把手培训学习班在输尿管软镜教学中的探讨 被引量:5
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作者 李钧 田野 +1 位作者 肖荆 王文营 《中国病案》 2016年第6期77-79,共3页
随着输尿管软镜技术的发展和普及,越来越多的医院开展了此类手术,相关问题也随之出现,规范化的技术培训也显得尤为必要。结合某院泌尿外科软镜技术的应用经验,提出了对软镜教学采用手把手的培训模式。自2014年-2015年共举办了20期培训班... 随着输尿管软镜技术的发展和普及,越来越多的医院开展了此类手术,相关问题也随之出现,规范化的技术培训也显得尤为必要。结合某院泌尿外科软镜技术的应用经验,提出了对软镜教学采用手把手的培训模式。自2014年-2015年共举办了20期培训班,效果良好。现对软镜手术技术和优势、普及和培训情况、当前培训模式和问题、学习中的误区和难点以及手把手教学模式中各环节的特点进行介绍和讨论,从中总结经验,以进一步达到手把手培训模式提高输尿管软镜教学效果的目的。 展开更多
关键词 泌尿外科 输尿管软镜 内镜 培训
Techniques and efficacy of flexible endoscopic therapy ofZenker's diverticulum 预览
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作者 Yaseen Perbtani Alejandro Suarez Mihir S Wagh 《世界胃肠内镜杂志:英文版(电子版)》 2015年第3期206-212,共7页
Zenker's diverticulum (ZD) is an abnormal hypopharyngealpouch often presenting with dysphagia. Treatment isoften sought with invasive surgical management of thediverticulum being the only mode of definitive therapy... Zenker's diverticulum (ZD) is an abnormal hypopharyngealpouch often presenting with dysphagia. Treatment isoften sought with invasive surgical management of thediverticulum being the only mode of definitive therapy.Primarily done by an open transcervical approachin the past, nowadays treatment is usually providedby otolaryngologists using a less invasive trans-oraltechnique with a rigid endoscope. When first described,this method grew into acceptance quickly due to itssimilar efficacy and vastly improved safety profilecompared to the open transcervical approach. However,the main limitation with this approach is that it may notbe suitable for all patients. Nonetheless, progress inthe field of natural orifice endoscopic surgery over thelast 10-20 years has led to the increase in utilization ofthe flexible endoscope in the treatment of ZD. Primarilyperformed by interventional gastroenterologists, thisapproach overcomes the prior limitation of its surgicalcounterpart and allows adequate visualization of thediverticulum independent of the patient's body habitus.Additionally, it may be performed without the useof general anesthesia and in an outpatient setting,thus further increasing the utility of this modality,especially in elderly patients with other comorbidities.Today, results in more than 600 patients have beendescribed in various published case series usingdifferent techniques and devices demonstrating a highpercentage of clinical symptom resolution with lowrates of adverse events. In this article, we present ourexperience with flexible endoscopic therapy of Zenker'sdiverticulum and highlight the endoscopic technique,outcomes and adverse events related to this minimallyinvasive modality. 展开更多
关键词 Zenker's DIVERTICULUM FLEXIBLE ENDOSCOPY Natural orifice endoscopic surgery Per-oral ENDOSCOPY DYSPHAGIA Cricopharyngeus MYOTOMY Cricopharyngeusseptotomy
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Transvaginal Approach for Nongynecologic Intraperitoneal Procedures 预览
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作者 José F. Noguera Gonzalo Martín +6 位作者 José M. Mu?oz Antonio Melero Raúl Sánchez Javier Valdivia Marcos Bruna Antonio Salvador Cristóbal Zaragoza 《临床医学国际期刊(英文)》 2014年第21期1417-1429,共13页
The minimally invasive surgery through natural orifices has revolutionized the laparoscopic surgery for abdominal procedures. The use of the vaginal approach is not new for gynecologists but it is a new concept for th... The minimally invasive surgery through natural orifices has revolutionized the laparoscopic surgery for abdominal procedures. The use of the vaginal approach is not new for gynecologists but it is a new concept for the non-gynecological laparoscopic surgeons. The use of this new approach has been used to perform some procedures and to extract specimens after a laparoscopic surgery, but we don’t know exactly the number of procedures performed until today. There are few papers with clinical experience and a lot of philosophical papers about NOTES. Our aim is to know how and how often we are using this new approach for non-gynecological abdominal minimally invasive procedures. With the revision of the PubMed publications we obtained a total of 268 articles, of which 125 were included in the analysis (46.64%). Cholecystectomy was the procedure more usually performed: there is a large clinical experience with a total of 2432 transvaginal cholecystectomies. Bariatric surgery, colectomy and appendectomy have been other surgical procedures with some clinical experience in the use of the transvaginal approach. Analyzing the publications on transvaginal approach, we observed that the use of the vaginal route for non-gynecological abdominal surgery was not anecdotal, with accumulative experience of more than 3000 patients reported in published studies. The use of the vaginal route has shown its safety, obtaining some additional benefits such as the aesthetic and the faster functional recovery. Dyspareunia, one of the most feared, has not been reported in studies as a concern to consider. 展开更多
关键词 TRANSVAGINAL SURGERY ENDOSCOPIC SURGERY LAPAROSCOPY Flexible ENDOSCOPY
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Gastrointestinalendoscopyinthepregnantwoman 预览
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作者 Friedel D Stavropoulos S +1 位作者 Iqbal S Cappell MS 《世界胃肠内镜杂志:英文版(电子版)》 2014年第5期156-167,共12页
About 20000 gastrointestinal endoscopies are performed annually in America in pregnant women. Gastrointestinal endoscopy during pregnancy raises the critical issue of fetal safety in addition to patient safety. Endosc... About 20000 gastrointestinal endoscopies are performed annually in America in pregnant women. Gastrointestinal endoscopy during pregnancy raises the critical issue of fetal safety in addition to patient safety. Endoscopic medications may be potentially abortifacient or teratogenic. Generally, Food and Drug Administration category B or C drugs should be used for endoscopy. Esophagogastroduodenoscopy(EGD) seems to be relatively safe for both mother and fetus based on two retrospective studies of 83 and 60 pregnant patients. The diagnostic yield is about 95% when EGD is performed for gastrointestinal bleeding. EGD indications during pregnancy include acute gastrointestinal bleeding, dysphagia > 1 wk, or endoscopic therapy. Therapeutic EGD is experimental due to scant data, but should be strongly considered for urgent indications such as active bleeding. One study of 48 sigmoidoscopies performed during pregnancy showed relatively favorable fetal outcomes, rare bad fetal outcomes, and bad outcomes linked to very sick mothers. Sigmoidoscopy should be strongly considered for strong indications,including significant acute lower gastrointestinal bleeding, chronic diarrhea, distal colonic stricture, suspected inflammatory bowel disease flare, and potential colonic malignancy. Data on colonoscopy during pregnancy are limited. One study of 20 pregnant patients showed rare poor fetal outcomes. Colonoscopy is generally experimental during pregnancy, but can be considered for strong indications: known colonic mass/stricture, active lower gastrointestinal bleeding, or colonoscopic therapy. Endoscopic retrograde cholangiopancreatography(ERCP) entails fetal risks from fetal radiation exposure. ERCP risks to mother and fetus appear to be acceptable when performed for ERCP therapy, as demonstrated by analysis of nearly 350 cases during pregnancy. Justifiable indications include symptomatic or complicated choledocholithiasis, manifested by jaundice, cholangitis, gallstone pancreatitis, or dilated choledochus. ERCP should be performed 展开更多
关键词 胃肠的内视镜检查法 ESOPHAGOGASTRODUODENOSCOPY 灵活 sigmoidoscopy COLONOSCOPY 内视镜后退 cholangiopancreatography TERATOGENICITY 内视镜的指示 内视镜检查法安全 内视镜的复杂并发症 怀孕
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101例食管异物并发症的影响因素及软式内镜治疗效果分析 被引量:13
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作者 闫秀娥 周丽雅 +2 位作者 林三仁 王晔 程志蓉 《中华医学杂志》 CAS CSCD 北大核心 2013年第32期2557-2561,共5页
目的分析食管异物嵌顿后并发症发生的相关影响因素及软式内镜的治疗效果。方法回顾性分析北京大学第三医院消化科2005年1月至2012年12月经北京大学第三医院消化科软式内镜下治疗的101例食管异物病例资料,其中男52例、女49例,年龄(49&... 目的分析食管异物嵌顿后并发症发生的相关影响因素及软式内镜的治疗效果。方法回顾性分析北京大学第三医院消化科2005年1月至2012年12月经北京大学第三医院消化科软式内镜下治疗的101例食管异物病例资料,其中男52例、女49例,年龄(49±21)岁。所有患者在行咽部局部麻醉并禁食4h以上后于消化科内镜中心行软式内镜下治疗。t检验或x^2检验比较组间差异。结果(1)异物嵌顿于食管上段及中段占到了所有食管异物的87.1%(88例),异物嵌顿后至异物取出的间隔时间在食管上、中、下段差异无统计学意义(P〉0.05)。(2)82.2%(83例)的食管异物患者在24h内就诊,99.0%(100例)的食管异物患者在48h内就诊。嵌顿的异物中食物类(包括食物团块、鱼刺、鸡骨及枣核)占到了76.2%(77例)。(3)上消化道造影诊断食管异物阳性率91.3%(21/23),胸部或腹部x线片诊断食管异物阳性率为24.1%(7/29),软式内镜取食管异物成功率94.1%(95例)。(4)所有异物中义齿取出难度最大,11例义齿嵌顿中4例失败。(5)并发症(除轻度划伤)发生率为48.5%(49例),穿孔率为3.0%(3例)。异物嵌顿食管后是否出现并发症与患者年龄、嵌顿位置、嵌顿时间、异物大小均无关(均P〉0.05),而与异物是否刺入食管壁、合并食管狭窄、异物种类有关(均P〈0.01)。异物嵌顿食管壁后是否出现穿孔则与上述因素均无关。结论异物在嵌顿食管后尤其是边缘锐利、刺人食管壁的异物,应尽可能在24h内取出。 展开更多
关键词 食管 异物 软式内镜
笔记, MANOS, SILS 和另外的新 laparoendoscopic 技术 预览
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作者 José F Noguera Angel Cuadrado 《世界胃肠内镜杂志:英文版(电子版)》 2012年第6期212-217,共6页
A new way of opening a body cavity can be a revolution in surgery.In 1980s,laparoscopy changed how surgeons had been working for years.Natural orifice translumenal endoscopic surgery(NOTES),minilaparoscopy-assisted n... A new way of opening a body cavity can be a revolution in surgery.In 1980s,laparoscopy changed how surgeons had been working for years.Natural orifice translumenal endoscopic surgery(NOTES),minilaparoscopy-assisted natural orifice surgery(MANOS),single incision laparoscopic surgery(SILS) and other new techniques are the new paradigm in our way of operating in the 21 st century.The development of these techniques began in the late 90s but they have not had enough impact to develop and evolve.Parallels between the first years of laparoscopy and NOTES can be made.Working for an invisible surgery,not only for cosmesis but for a less invasive surgery,is the target of NOTES,MANOS and SILS performed by surgeons and endoscopists over the last 10 years.The future flexible endoscopic platforms and the fusion between laparoscopic instruments and devices and robotic surgery will be a great advance for 'scarless surgery'. 展开更多
关键词 LAPAROSCOPY ENDOSCOPY NATURAL ORIFICE translumenal endoscopic SURGERY Single INCISION laparoscopic SURGERY Minilaparoscopy-assisted NATURAL ORIFICE SURGERY Flexible ENDOSCOPY
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应用纤维胆道镜治疗术后残石的体会 预览 被引量:1
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作者 曹嘉华 李庆怀 《甘肃医药》 1994年第2期 73-74,共2页
本文报道纤维胆道镜治疗手术后残余结石42例,总有效率达到95.2%,结石取净率85.7%。评价了内镜取石的临床价值,认为是目前清除胆管残余结石最有效的方法,结果证明疗效良好。并分别介绍了肝外、肝内胆管结石、嵌顿性结石等的取石技术操... 本文报道纤维胆道镜治疗手术后残余结石42例,总有效率达到95.2%,结石取净率85.7%。评价了内镜取石的临床价值,认为是目前清除胆管残余结石最有效的方法,结果证明疗效良好。并分别介绍了肝外、肝内胆管结石、嵌顿性结石等的取石技术操作要领及难点,以及预防并发症的措施。 展开更多
关键词 胆管结石 纤维胆道镜 内镜治疗
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三种输尿管镜治疗输尿管上段结石的疗效比较
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作者 张晓璐 李赛扬 +3 位作者 詹相诚 陆钧 刘群龙 许云飞 《现代生物医学进展》 CAS 2018年第21期4041-4045,共5页
目的:比较半硬性输尿管镜、输尿管软镜、孙氏末段可弯输尿管镜治疗输尿管上段结石的临床疗效,为临床上治疗方式的选择提供参考。方法:回顾性分析2015年8月到2017年12月间于上海市第十人民医院泌尿外科因输尿管上段结石行输尿管镜下钬激... 目的:比较半硬性输尿管镜、输尿管软镜、孙氏末段可弯输尿管镜治疗输尿管上段结石的临床疗效,为临床上治疗方式的选择提供参考。方法:回顾性分析2015年8月到2017年12月间于上海市第十人民医院泌尿外科因输尿管上段结石行输尿管镜下钬激光治疗的515例患者的临床资料。按照所用输尿管镜类型分为3组:硬镜组(给予半硬性输尿管镜治疗)297例,软镜组172例(给予输尿管软镜治疗),孙氏镜组(给予孙氏末段可弯输尿管镜治疗)46例。比较三组的手术时间、一期清石率、术后住院时间及术中、术后并发症。结果:硬镜组、软镜组、孙氏镜组清石率分别为81.5%、94.2%、95.7%,其中软镜组、孙氏镜组清石率显著高于硬镜组(P<0.05)。硬镜组、软镜组、孙氏镜组术中并发症发生率分别为18.9%、5.8%、4.3%,其中硬镜组术中并发症发生率显著高于软镜组和孙氏镜组(P<0.05),三组术后并发症发生率整体比较差异无统计学意义(P>0.05)。硬镜组、软镜组、孙氏镜组平均手术时间分别为(28.6±6.2)min、(49.4±12.4)min、(26.1±6.5)min,软镜组平均手术时间显著高于硬镜组及孙氏镜组,差异有统计学意义(均P<0.05)。硬镜组、软镜组、孙氏镜组平均住院时间分别为(5.4±3.2)d、(6.7±5.7)d、(5.0±2.5)d,软镜组住院时间显著高于硬镜组和孙氏镜组,差异有统计学意义(均P<0.05)。结论:软镜清石效果和手术安全性较硬镜更有优势,但手术耗时长,患者术后住院时间长。孙氏镜有望成为治疗输尿管上段结石的更佳选择。 展开更多
关键词 输尿管结石 上段 半硬性输尿管镜 输尿管软镜 孙氏末段可弯输尿管镜 疗效
根本原因分析法在降低软式电子内窥镜故障率中的应用 预览 被引量:6
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作者 陈云 陈慕蓉 王上东 《中国医疗设备》 2017年第10期97-99,104共4页
本文介绍了软式电子内窥镜的基本结构和常见故障,运用根本原因分析法找出故障率高的原因,进而制定并执行相关的改进计划。结果发现,改进后故障率明显下降,使用效率得到提升。
关键词 根本原因分析法 软式电子内窥镜 故障率 医疗设备管理
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早期胃癌的内镜诊断进展 预览
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作者 赖昌江 梁列新 《中国临床新医学》 2017年第12期1226-1230,共5页
随着内镜技术的发展,不断提高了早期胃癌的诊断率。而胃癌的早期诊断和治疗,将明显改善患者的预后与生存率。该文阐述了窄带成像技术、智能分光比色技术、I-san、共聚焦激光显微内镜、蓝色激光成像等先进手段在早期胃癌诊断中的研究进展。
关键词 早期胃癌 窄带成像技术 智能分光比色技术 共聚焦激光显微内镜 蓝色激光成像
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Digital chromoendoscopy utilization in clinical practice: A survey of gastroenterologists in Connecticut 预览
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作者 Karl M Langberg Neil D Parikh +3 位作者 Yanhong Deng Maria Ciarlegio Loren Laine Harry R Aslanian 《世界胃肠药理与治疗学杂志:英文版(电子版)》 2016年第2期268-273,共6页
AIM:To use a survey to characterize and identify potential barriers to the use of digital chromoendoscopy(DC)by practicing gastroenterologists.METHODS:An anonymous,internet-based survey was sent to gastroenterologists... AIM:To use a survey to characterize and identify potential barriers to the use of digital chromoendoscopy(DC)by practicing gastroenterologists.METHODS:An anonymous,internet-based survey was sent to gastroenterologists in Connecticut who were members of one of three national gastrointestinal organizations.The survey collected demographic information,frequency of DC use,types of procedures that the respondent performs,setting of practice(academic vs community),years out of training,amount of training in DC,desire to have DC training and perceived barriers to DC use.Responses were collected anonymously.The primary endpoint was the proportion of endoscopists utilizing DC.Associations between the various data collected were analyzed usingχ2 test.RESULTS:One hundred and twenty-four gastroenterologists(48%)of 261 who received the online survey responded.Seventy-eight percent of surveyed gastroenterologists have used DC during the performance of upper endoscopy and 81%with lower endoscopy.DC was used in more than half of procedures by only 14%of gastroenterologists during upper endoscopy and 12%during lower endoscopy.Twenty-three percent(upper)and 21%(lower)used DC more than one quarter of the time.DC was used for 10%or less of endoscopies by 60%(upper)and53%(lower)of respondents.Endoscopists reported lack of training as the leading deterrent to DC use with36%reporting it as their primary deterrent.Eighty-nine percent of endoscopists never received formal training in DC.Lack of time(30%of respondents),lack of evidence(24%)and lack of reimbursement(10%)were additional deterrents.There were no differences in DC use relative to academic vs community practice setting or years out of training.CONCLUSION:DC is used infrequently by most endoscopists,primarily due to a lack of training.Training opportunities should be expanded to meet the interest expressed by the majority of endoscopists. 展开更多
关键词 Endoscopy Surveys and questionnaires Gastrointestinal diseases Clinical practice patterns Esophageal NEOPLASMS COLONIC NEOPLASMS NARROW band IMAGING Flexible spectral IMAGING color enhancement I-scan
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智能染色内镜联合放大内镜对早期胃癌的诊断价值 预览
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作者 王磊 时军利 +1 位作者 张月晓 李炳庆 《世界华人消化杂志》 CAS 2016年第26期3809-3813,共5页
目的通过研究智能染色内镜(flexible spectral imaging color,FICE)联合放大内镜在早期胃癌中的诊断准确度,探讨其临床应用价值.方法回顾性分析承德医学院附属医院自2015-03/2015-12行胃镜检查怀疑早期胃癌并行FICE下放大观察的内镜图... 目的通过研究智能染色内镜(flexible spectral imaging color,FICE)联合放大内镜在早期胃癌中的诊断准确度,探讨其临床应用价值.方法回顾性分析承德医学院附属医院自2015-03/2015-12行胃镜检查怀疑早期胃癌并行FICE下放大观察的内镜图片,根据放大内镜下胃黏膜表面微结构、微血管及有无边界线,制定早期胃癌的内镜诊断标准,通过此标准对胃内病变做出诊断,再与病理比较,得出胃镜诊断早期胃癌的敏感性及特异性.结果共有177例图像进行了回顾性分析,病理诊断为低级别上皮内瘤变26例,高级别上皮内瘤变12例,慢性炎症或萎缩性胃炎或肠上皮化生患者139例,FICE联合放大内镜诊断上皮内瘤变的敏感性为68.4%,特异性为87.8%,Youden指数为56.2%.诊断为早期胃癌的敏感性为75.0%,特异性为100%,Youden指数75.0%.结论根据我们制定的标准,FICE联合放大内镜可提高胃镜诊断早期胃癌的准确性. 展开更多
关键词 早期胃癌 智能染色内镜 胃镜
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Current status of minimally invasive endoscopicmanagement for Zenker diverticulum 预览 被引量:2
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作者 Alberto Aiolfi Federica Scolari +1 位作者 Greta Saino Luigi Bonavina 《世界胃肠内镜杂志:英文版(电子版)》 2015年第2期87-94,共8页
Surgical resection has been the mainstay of treatment ofpharyngoesophageal (Zenker) diverticula over the pastcentury. Developments in minimally invasive surgeryand new endoscopic devices have led to a paradigmchange... Surgical resection has been the mainstay of treatment ofpharyngoesophageal (Zenker) diverticula over the pastcentury. Developments in minimally invasive surgeryand new endoscopic devices have led to a paradigmchange. The concept of dividing the septum betweenthe esophagus and the pouch rather than resecting thepouch itself has been revisited during the last threedecades and new technologies have been investigatedto make the transoral operation safe and effective. Theinternal pharyngoesophageal myotomy accomplished through the transoral stapling approach has been shown to effectively relieve outflow obstruction and restore physiological bolus transit in patients with medium size diverticula. Transoral techniques, either through a rigid device or by flexible endoscopy, are gaining popularity over the open surgical approach due the low morbidity, the fast recovery time and the fact that the procedure can be safely repeated. We provide an analysis of the the current status of minimally invasive endoscopic management of Zenker diverticulum. 展开更多
关键词 ZENKER DIVERTICULUM Endoscopic STAPLING Cricopharyngeal MYOTOMY DIVERTICULECTOMY Interventionalflexible ENDOSCOPY
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虚拟色素内镜在小肠黏膜病损成像中的应用价值 预览
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作者 孔刚 刘虹 +1 位作者 龚志军 郭建平 《中国内镜杂志》 北大核心 2015年第6期603-606,共4页
目的评价虚拟色素内镜在小肠黏膜病损成像中的应用价值。方法采用单中心回顾性研究方法,将白光胶囊内镜获取的49例100处小肠病损图像,由两位内镜专家分别在FIC E1、FIC E2、FIC E3及BF 4种条件下重建病损图像,并与白光胶囊内镜获取图像... 目的评价虚拟色素内镜在小肠黏膜病损成像中的应用价值。方法采用单中心回顾性研究方法,将白光胶囊内镜获取的49例100处小肠病损图像,由两位内镜专家分别在FIC E1、FIC E2、FIC E3及BF 4种条件下重建病损图像,并与白光胶囊内镜获取图像进行比较。K appa系数评价两位专家判别结果的一致性。100处小肠病损包括39处血管病损、49处溃疡(糜烂)病损及12例处水肿(萎缩)病损。结果采用FIC E1、FIC E2、FIC E3和BF图像重建条件后,小肠黏膜病损图像质量提高率分别为77%(77/100)、74%(74/100)、41%(41/100)和39%(39/100),两位专家之间评价一致性程度分别为89%[k=0.833(P〈0.001),95%C I:0.741-0.925]、85%[k=0.764(P〈0.001),95%C I:0.654-0.874]、66%[k=0.486(P〈0.001),95%C I:0.345-0.627]及79%[k=0.593(P〈0.001),95%C I:0.438-0.748]。结论在常规SBC E-W L对小肠病损成像与表征不直观情况下,可使用虚拟色素内镜检查(尤其是FIC E1),可将虚拟色素内镜检查作为常规白光SBC E检查的补充,用以评估难以解读的内镜图像。 展开更多
关键词 胶囊内镜 虚拟内镜 小肠内镜 可扩展电子分光色彩强调技术
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Virtual chromoendoscopy in small bowel capsule endoscopy: New light or a cast of shadow? 预览
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作者 José Cotter Joana Magalh?es +5 位作者 Francisca Dias de Castro Mara Barbosa Pedro Boal Carvalho Sílvia Leite Maria Jo?o Moreira Bruno Rosa 《世界胃肠内镜杂志:英文版(电子版)》 2014年第8期359-365,共7页
AIM: To evaluate whether virtual chromoendoscopy can improve the delineation of small bowel lesions previously detected by conventional white light small bowel capsule endoscopy(SBCE). METHODS: Retrospective single c... AIM: To evaluate whether virtual chromoendoscopy can improve the delineation of small bowel lesions previously detected by conventional white light small bowel capsule endoscopy(SBCE). METHODS: Retrospective single center study. One hundred lesions selected from forty-nine consecutive conventional white light SBCE(SBCE-WL) examinations were included. Lesions were reviewed at three Flexible Spectral Imaging Color Enhancement(FICE) settings and Blue Filter(BF) by two gastroenterologists with ex-perience in SBCE, blinded to each other’s findings, whoranked the quality of delineation as better, equivalent or worse than conventional SBCE-WL. Inter-observer percentage of agreement was determined and analyzed with Fleiss Kappa(k) coefficient. Lesions selected for the study included angioectasias(n = 39), ulcers/ero-sions(n = 49) and villous edema/atrophy(n = 12). RESULTS: Overall, the delineation of lesions was im-proved in 77% of cases with FICE 1, 74% with FICE 2, 41% with FICE 3 and 39% with the BF, with a percent-age of agreement between investigators of 89%(k = 0.833), 85%(k = 0.764), 66%(k = 0.486) and 79%(k = 0.593), respectively. FICE 1 improved the delineation of 97.4% of angioectasias, 63.3% of ulcers/erosions and 66.7% of villous edema/atrophy with a percentage of agreement of 97.4%(k = 0.910), 81.6%(k = 0.714) and 91.7%(k = 0.815), respectively. FICE 2 improved the delineation of 97.4% of angioectasias, 57.1% of ulcers/erosions and 66.7% of villous edema/atrophy, with a percentage of agreement of 89.7%(k = 0.802), 79,6%(k = 0.703) and 91.7%(k = 0.815), respectively. FICE 3 improved the delineation of 46.2% of angioecta-sias, 24.5% of ulcers/erosions and none of the cases of villous edema/atrophy, with a percentage of agreement of 53.8% [k = not available(NA)], 75.5%(k = NA) and 66.7%(k = 0.304), respectively. The BF improved the delineation of 15.4% of angioectasias, 61.2% of ulcers/erosions and 25% of villous edema/atrophy, with a per-centage of agreement of 76.9%(k = 0.558), 81.6%(k = 0.570) and 25.0%(k 展开更多
关键词 Capsule ENDOSCOPY VIRTUAL chromoendos-copy Small bowel ENTEROSCOPY Flexible Spectral IMAGING Color Enhancement ENDOSCOPY IMAGING review
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