Endoscopic Clipping with a New Rotatable Clip‐Device and a Long Clip
Endoscopic Clipping with a New Rotatable Clip‐Device and a Long Clip
复制标题
使用新型可旋转夹子装置和长夹子进行内窥镜夹闭
DOI：
10.1111/j.1443-1661.1996.tb00428.x
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发表时间：
1996
影响因子：
5.3
通讯作者：
T. Kouzu
中科院分区：
文献类型：
--
作者：
T. Hachisu;H. Yamada;Shin‐ichi Satoh;T. Kouzu
摘要：我们开发了一种可旋转、高度耐用的夹闭器械（可旋转夹闭器械）和一种长夹，可用于有效夹持大咬合的组织。然而，长夹的应用需要特殊的加强夹装置。新型可旋转成形夹器械可适当与长成形夹联合使用，因为其强度和可折叠性得到改善。使用可旋转夹器械对133例患者进行内镜治疗，包括43例需要消化道出血止血的患者、43例息肉切除术后预防性夹闭的患者、39例内镜粘膜切除术（EMR）后粘膜闭合的患者和10例食管静脉曲张预防性结扎的患者。长夹主要用于EMR后的粘膜闭合。研究发现，可旋转成形夹器械尤其适用于软出血病变的止血。息肉切除术后预防性夹闭预防了41例患者中的40例并发症。EMR后通过夹闭进行粘膜闭合可预防所有39例患者的并发症，可旋转夹器械的可重复性和长夹的大咬合能力极大地促进了粘膜缺损的闭合，尤其是大缺损。在接受预防性食管静脉曲张夹闭术的10例患者中，可旋转夹器械可牢固夹持并有效结扎静脉曲张。在内窥镜治疗期间，尽管频繁进行了高压蒸汽灭菌和夹闭手术，但4件夹闭器械中有3件功能正常。
Abstract: We developed a rotatable, highly durable clipping device (rotatable clip‐device) and a long clip which can be used to effectively grasp a large bite of tissue. However, application of the long clip required a special reinforced clipping device. The new rotatable clip‐device can be appropriately used in combination with the long clip because of its improved strength and rotatability. The rotatable clip‐device was used for endoscopic treatment of 133 patients, including 43 requiring hemostasis of gastrointestinal bleeding, 43 with prophylactic clipping following polypectomy, 39 with mucosal closure following endoscopic mucosal resection (EMR), and 10 undergoing prophylactic ligation of esophageal varices. The long clips were used mainly for mucosal closure after EMR. The rotatable clip‐device was found to be especially useful for hemostasis of soft bleeding lesions. Prophylactic clipping following polypectomy prevented complications in 40 out of 41 patients. Mucosal closure by means of clipping following EMR prevented complications in all 39 patients, and the rotatability of the rotatable clip‐device and the large bite capacity of the long clip greatly facilitated closing mucosal defects, especially large defects. In the 10 patients who underwent prophylactic clipping of esophageal varices, the rotatable clip‐device allowed the varices to be grasped securely and ligated effectively. During endoscopic treatment, three of the four clip‐devices functioned normally despite frequent auto‐claving and clipping procedures.