观察胃镜下碎石器联合圈套器治疗老年人巨大胃石的临床疗效。

选择2020年2月至2023年5月天津医科大学第二医院收治的确诊为巨大胃石症的103例老年住院患者为研究对象。其中51例患者采用内镜下传统碎石器治疗（对照组），余52例患者采用内镜下碎石器联合圈套器治疗（观察组），两组患者碎石后均口服碳酸氢钠治疗。比较两组患者的治愈率、手术操作时间、患者舒适度、碎石后进餐时间、住院时间及住院费用。计量资料的比较采用t检验；计数资料的比较采用χ²检验。

两组患者治疗总有效率的差异无统计学意义（χ²=0.020，P>0.05）。观察组手术操作时间明显短于对照组、数字视觉模拟评分明显低于对照组（t=3.751、9.578，P<0.01）。两组患者碎石后进餐时间的差异无统计学意义（t=0.923，P>0.05）。观察组患者碎石器使用数量和住院费用均明显少于对照组（t=4.057、2.911，P<0.01），但两组患者住院时间的差异无统计学意义（t=0.463，P>0.05）。

胃镜下碎石器联合圈套器治疗老年人巨大胃石具有手术操作时间短、患者舒适度高、住院费用低等优点，值得临床推广。

To observe the therapeutic effect of gastroscopy combined with stone crushers and snares in the treatment of giant gastric stones in elderly patients.

A total of 103 elderly patients with giant gastric stones diagnosed under endoscopy hospitalized in the Second Hospital of Tianjin Medical University from February 2020 to May 2023 were enrolled. All patients were randomly divided into the control group (51 cases) and the observation group (52 cases) according to a random number table. The control group was treated with traditional lithotripters under endoscopy, followed by oral sodium bicarbonate. The observation group was treated with lithotripters combined with snares, followed by oral sodium bicarbonate. The total effective rate, endoscopic operation time, patient comfort, first meal time, length of hospital stay and total hospitalization cost between two groups were compared using t test or χ² test.

There was no statistically significant difference in the total effective rate between the two groups (χ²=0.020, P > 0.05). The operation time of the observation group was significantly less than that of the control group (t=3.751, P < 0.01). The visual analogue scale score in observation group was significantly lower than that in the control group (t=9.578, P < 0.01). The number of stone crushers used in the observation group was significantly less than that in the control group (t=4.057, P < 0.01). The hospitalization cost in the observation group was significantly lower than that in the control group (t=2.911, P < 0.01). There was no statistically significant difference in average meal time and length of hospital stay between the two groups (t=0.923 and 0.463, P > 0.05).

The combination of gastroscopic lithotripsy and snare for the treatment of giant gastric stones in the elderly has the advantages of short surgical operation time, high patient comfort, and low hospitalization costs, which is worthy of clinical promotion.