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采用非处方透明质酸制剂行内镜下黏膜切除术

发布日期:2014-1-29 12:40:39 文章来源:GIE 作者次数:1234

    采用非处方透明质酸制剂行内镜下黏膜切除术

    背景

    为实施内镜下黏膜切除术,使用透明质酸(HA)可使黏膜长期持续隆起,且使隆起明显,但是使用透明质酸费用昂贵,而且使用不方便,因此其使用受到限制。

    目的

    评估为实施内镜下黏膜切除术而使用0.15%的透明质酸制剂(非处方)的安全性和疗效。

    设计

    本研究为回顾性研究。

    环境

    退伍军人管理医院和大学医院。

    患者

    30例患者患有32处结肠病变和1处十二指肠病变。

    干预

    采用透明质酸行内镜下黏膜切除术。

    主要测量结果

    整块切除率和并发症。

    结果

    对所有病例成功实施内镜下黏膜切除术。在28处病变中,有26处被整块切除,且直径达到25 mm2处病变带有之前尝试切除的纤维化病变,而且这两处病变有残留组织,这样必须用氩等离子体灼烧。5处病变直径为30mm60mm,它们都需要分段切除。出现一例并发症,即大肠镜息肉切除术后出血。

    局限性

    患者数量少,回顾性设计。

    结论

    内镜下黏膜切除术可在使用便宜的非处方药(0.15%的透明质酸制剂)情况下被安全有效地实施。需进一步研究来证实本研究结果,并来比较盐溶液制备的该透明质酸制剂的安全性和疗效。

    缩写词HA,透明质酸。


    Endoscopic mucosal resection with an over-the-counter hyaluronate preparation

    Background

    Hyaluronic acid (HA) provides a long-lasting and distinct mucosal elevation for EMR, but expense and inconvenience have limited its adoption.

    Objective

    To evaluate the safety and efficacy of an over-the-counter 0.15% HA preparation for EMR.

    Design

    Retrospective study.

    Setting

    Veterans AdministrationHospital and university hospital.

    Patients

    30 patients with a total of 32 colonic lesions and 1 duodenal lesion.

    Intervention

    EMR by using HA.

    Main Outcome Measurements

    En bloc resection rate and complications.

    Results

    EMR was successful in all cases. En bloc resection was achieved in 26 of the 28 lesions up to25 mmin diameter. Two lesions, both with fibrosis from prior attempted resection, had trace residual tissue necessitating cauterization with argon plasma. Five lesions measuring30 mmto60 mmall required piecemeal resection. There was one complication, a postpolypectomy bleed.

    Limitations

    Small number of patients and retrospective design.

    Conclusions

    EMR may be performed safely and effectively by using an inexpensive, over-the-counter 0.15% HA preparation. Further studies are needed to verify the results of this study and to compare the safety and efficacy of this HA preparation with saline solution.

    Abbreviation:  HA, hyaluronic acid

     

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