离体猪胃黏膜下隆起性病变模型的建立及其在内镜黏膜下剥离术中的应用研究
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中国科学院大学深圳医院 消化内科

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Establishment of in vitro porcine gastric model of submucosal eminence lesion and its application in endoscopic submucosal dissection
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    摘要:

    目的 探讨离体猪胃黏膜下隆起性病变模型的制作方法及其在内镜黏膜下剥离术(ESD)中的应用。方法 应用硅橡胶印模材料和直径1 cm、2 cm、3 cm钢球制成半球形阴模,将生牛肉糜放进阴模,两个阴模对合固定,置入100℃水中煮沸20 min后制成球形肿物模型。选取离体猪胃6只,将球形肿物模型经猪胃浆膜层切口置入黏膜下层,每只离体猪胃的胃底、胃体、胃窦部各置入1枚,直径分别为1 cm、2 cm、3 cm。应用胃镜及内镜超声对模型进行观察,并对黏膜下隆起性病变行ESD。结果 6只猪胃共置入肿物模型18枚,其中17枚成功置入,1例失败。置入的17枚肿物模型在内镜下均表现为明显向腔内凸起的占位改变,表面黏膜与周边黏膜对比无明显改变。内镜超声下表现为位于黏膜下层的混合回声占位。对肿物模型进行ESD,与实际ESD操作过程基本一致,未出现肿物模型脱出、破碎等影响操作的情况。结论 本方法制作的胃黏膜下隆起性病变模型可较好复制疾病状态,为胃黏膜下隆起性病变内镜治疗方法研究及内镜医师培训提供了一个较为合适的模型。

    Abstract:

    Objective To establish the in vitro porcine gastric model of submucosal eminence lesion and its application for endoscopic submucosal dissection(ESD). Methods Silicone rubber impression materials and steel balls with diameters of 1 cm, 2 cm, and 3 cm were used to make three pairs of spherical cavities. And then raw ground beef was put into spherical cavities and boiled for 20 minutes to make spherical mass models. Six isolated porcine stomach with esophagus and duodenum were selected. The mass models with diameters of 1 cm, 2 cm and 3 cm were imbedded respectively into the submucosa of fundus, body, and antrum of porcine stomach through the incision on serosal layer. The submucosal masses were observed by endoscopy and endoscopic ultrasonography and underwent ESD. Results A total of 18 mass models were constructed in 6 porcine stomachs, of which 17 models were successfully established and 1 failed. Typical endoscopic characteristics of gastric submucosal eminence lesions were found in the 17 models. Endoscopic ultrasonography showed that these models originated from submucosal layer and demonstrated mixed echo. ESD was successfully performed in the porcine gastric models of submucosal eminence lesions, and all models were not broken or detached. Conclusion The in vitro porcine gastric model of submucosal eminence lesions can well replicate disease station and provide a suitable model for study on endoscopic therapy of submucosal eminence lesion and training of endoscopists.

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周应生,朱惠明,王嘉敏,等.离体猪胃黏膜下隆起性病变模型的建立及其在内镜黏膜下剥离术中的应用研究[J].中华消化内镜杂志,2019,36(11):831-835.

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  • 收稿日期:2018-12-11
  • 最后修改日期:2019-10-23
  • 录用日期:2019-01-16
  • 在线发布日期: 2019-11-29
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