2026 年第 1 期 第 21 卷

内镜用伞型喷洒管在上消化道出血患者医用胶内镜止血治疗中的应用及操作分析

Application and operation analysis of umbrella type spray tube for endoscope in the treatment of upper gastrointestinal bleeding patients with medical glue endoscopy

作者：李奇张杰代静曹艳鞠红岩杨军

英文作者：Li Qi Zhang Jie Dai Jing Cao Yan Ju Hongyan Yang Jun

单位：首都医科大学附属北京安贞医院消化内科，北京100029

英文单位：Department of Gastroenterology Beijing Anzhen Hospital Capital Medical University Beijing 100029 China

关键词：上消化道出血；内镜止血；医用胶；内镜操作

英文关键词：Uppergastrointestinalbleeding;Endoscopichemostasis;Medicalglue;Endoscopicoperation

• 摘要：

• 目的 探讨在上消化道出血患者通过医用胶进行内镜下止血治疗中内镜用伞型喷洒管、原装直头喷洒管的应用及操作分析。方法 回顾性分析首都医科大学附属北京安贞医院2022年1月至2024年12月因上消化道出血采用医用胶进行内镜下止血治疗的患者202例，根据使用的喷洒管分为直头喷洒管组（对照组，147例）和止血伞喷洒管组（观察组，55例）。分析2组创面喷洒效果数据、内镜堵塞情况等。结果 观察组与对照组治疗检查时间比较差异无统计学意义（P＞0.05），观察组喷洒及观察时间长于对照组（P＜0.001）。观察组喷洒装置在十二指肠球部溃疡、贲门撕裂症出血部位喷洒医用胶后，将伞部收回外鞘管内，可清晰观察喷洒后创面。对照组喷洒医用胶后，镜头模糊不清，立即退镜。观察组医用胶喷洒后镜头清晰度优52例、良3例，对照组优76例、良22例、差49例，2组比较差异有统计学意义（χ2＝31.954，P＜0.001）。观察组胶管堵塞比例低于对照组［0（0/55）比7.5%（11/147）］（χ2＝4.362，P=0.037）。统计科室近3年因对照组喷洒后医用胶堵塞的内镜返厂维修次数11次，花费54 893元，观察组医用胶未出现堵塞，费用为0元。结论 内镜用伞型喷洒管在医用胶喷洒止血后，可清晰观察创面的喷洒效果，管腔阻塞率及维修成本方面均低于对照组医用胶原装直头喷洒管。

• Objective To explore the application and operation analysis of umbrella type spray tube and original straight head spray tube in endoscopic hemostasis with medical glue in patients with upper gastrointestinal bleeding. Methods A total of 202 patients with upper gastrointestinal bleeding who underwent endoscopic hemostasis with medical glue in Beijing Anzhen Hospital, Capital Medical University from January 2022 to December 2024 were retrospectively analyzed. According to the spray tube used, they were divided into straight head spray tube group (control group, 147 cases) and hemostatic umbrella spray tube group (observation group, 55 cases). The spraying effect data and endoscopic blockage of the two groups were analyzed. Results There was no significant difference in the treatment examination time between the observation group and the control group (P>0.05). The spraying and observation time of the observation group was longer than that of the control group (P<0.001). In the observation group, after spraying medical glue on the bleeding site of duodenal bulb ulcer and cardia laceration, the umbrella was retracted into the outer sheath tube, and the wound after spraying could be clearly observed. In the control group, after spraying medical glue, the lens was blurred, and the lens was withdrawn immediately. There were 52 cases of excellent lens clarity and 3 cases of good lens clarity in the observation group after medical glue spraying, there were 76 cases of excellent lens clarity, 22 cases of good lens clarity and 49 cases of poor lens clarity in the control group, and the difference between the two groups was statistically significant (χ2=31.954, P<0.001). The proportion of rubber tube blockage in the observation group was lower than that in the control group ［0(0/55) vs 7.5%(11/147)］(χ2=4.362, P=0.037). In recent 3 years, the number of endoscopic repairs due to the blockage of medical glue after spraying in the control group was 11 times, and the cost was 54 893 yuan. The medical glue was not blocked in the observation group, and the cost was 0 yuan. Conclusion  sThe umbrella type spray tube used in endoscope can clearly observe the spraying effect of medical glue on the wound after bleeding, and the plug rate in the lumen and maintenance cost are lower than those of the control group.