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一次性活检钳在胃肠内镜检查中的适用性:与可重复使用活检钳的直接比较。

Adequacy of disposable biopsy forceps for gastrointestinal endoscopy: a direct comparison with reusable forceps.

作者信息

Yang R, Vuitch F, Wright K, McCarthy J

机构信息

Department of Internal Medicine, University of Texas, Southwestern Medical Center, Dallas.

出版信息

Gastrointest Endosc. 1990 Jul-Aug;36(4):379-81. doi: 10.1016/s0016-5107(90)71069-3.

Abstract

Disposable plastic biopsy forceps were compared prospectively to reusable stainless steel forceps. Thirty consecutive patients underwent a total of 249 biopsies, 124 with the disposable forceps, and 125 with reusable forceps. Biopsy locations included the esophagus, stomach, small intestine, colon, and common bile duct. Specimens were compared microscopically to determine overall surface area, depth, adequacy, and diagnostic result. The disposable biopsy forceps yielded specimens which were 37% smaller when compared with the reusable forceps. In five of the comparisons, minor differences in histological findings were noted between the two groups of biopsy specimens, but these differences did not alter the pathological diagnosis. However, in three cases in which superficial specimens were obtained, an underlying carcinoma was missed with the disposable forceps. Our study documents the utility of disposable biopsy forceps for mucosal lesions. In addition, there were 11 mechanical failures in 38 biopsy attempts with the plastic biopsy forceps. These forceps appear to be limited in their capacity to obtain adequate specimens from firm tissue or when submucosal biopsy samples are required, and they will require refinements in design to duplicate specimen quality obtained by traditional reusable forceps. Disposable forceps are particularly suitable for biopsy of mucosal lesions in patients with possible communicable disease, and they should help to reduce cross-contamination in the gastroenterology laboratory.

摘要

对一次性塑料活检钳与可重复使用的不锈钢活检钳进行了前瞻性比较。连续30例患者共进行了249次活检,其中124次使用一次性活检钳,125次使用可重复使用的活检钳。活检部位包括食管、胃、小肠、结肠和胆总管。对标本进行显微镜检查以确定总体表面积、深度、充分性和诊断结果。与可重复使用的活检钳相比,一次性活检钳获取的标本小37%。在五次比较中,两组活检标本的组织学结果存在微小差异,但这些差异并未改变病理诊断。然而,在三例获取浅表标本的病例中,一次性活检钳漏诊了潜在的癌。我们的研究证明了一次性活检钳对黏膜病变的实用性。此外,使用塑料活检钳进行的38次活检尝试中有11次出现机械故障。这些活检钳从坚实组织获取足够标本的能力似乎有限,或者在需要黏膜下活检样本时能力有限,并且需要改进设计以复制传统可重复使用活检钳所获得的标本质量。一次性活检钳特别适合对可能患有传染病的患者进行黏膜病变活检,并且它们应有助于减少胃肠病学实验室中的交叉污染。

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