内镜下行电化学介入术在胃出口和十二指肠恶性梗阻中的应用  

Application of electrochemical interventional therapy under endoscope to treatment of malignant gastroduodenal obstruction

作　　者：毕明刚 陈文琰 石崇军 解群 李彦 王蕊贤 孙风霞 王波云 

机构地区：[1]河北省石家庄燕赵医院消化内科,河北石家庄050021

出　　处：《中国内镜杂志》2006年第3期289-290,292,共3页China Journal of Endoscopy

摘　　要：目的探讨胃出口、十二指肠恶性梗阻时行内镜下电化学介入术在临床中的价值。方法23例病人中,胃窦癌5例,胃窦癌术后复发伴吻合口狭窄6例,贲门癌术后复发伴幽门梗阻3例,结肠癌晚期伴胆管、十二指肠恶性梗阻2例,胰头癌浸润十二指肠3例,十二指肠癌4例。所有患者均在内镜下行电化学介入术。结果电化学介入术一次置放电极成功17例,其中4例因病变处梗阻时间较长后才入院治疗,电极难以通过,先经内镜行微波烧灼,形成小通道后,在导丝引导下放电极。经治疗23例病人,梗阻完全缓解(CR)14例,部分缓解(PR)5例,稍有改善(MR)2例,病情无改善(NC)2例,总有效率(CR+PR)82.6%,未发生穿孔、大出血等严重并发症。结论内镜下行电化学介入术治疗胃出口和十二指肠恶性狭窄,能明显改善患者生存质量,是一种安全、有效的治疗方法,值得推广。[Objective] To explore the role of electrochemical interventional therapy under endoscope in treating malignant gastroduodenal obstruction, [Methods] Totally, 23 patients were enrolled into this study, including 5 eases of gastrie antrum earcinoma, 6 cases of postoperative recurrent gastric antrum earcinoma complicated by anastotootle stenosis, 3 eases of postoperative reeurrent of cardiac cancer, 2 cases of late colon cancer complicated with malignant obstruction of bile duct and duodenum, and 3 eases of duodenal infiltration by carcinoma of head of pancrcas. All of the patients underwent electrochemical interventional therapy under endoscope. [Results] In electroehemical interventional therapy, electrodes were successively put in right place at one time in 1.7 patients. Of these 17 patients, 4 were hospitalized after suffering from stenosis for a long period of time, electrodes were hard to put through at first. Therefore, endoscopic cautery was performed before hand to produce small cannels, through which electrodes were put onto the right spots with help of guide wire. Following the treatment, complete remission （CR） was achieved in 14 out of the 23 patients; partial remission （PR） was obtained in 5 patients; marginal remission （MR） in 2; no-remission （NR） in 2 cases with a overall effectiveness （CR＋PR） of 82.6%. No such severe complications were encountered as perforation and massive hemorrhage. [ Conclusions] Electrochemical interveotional therapy under endoscope was a safe. effective therapeutic option in treating malignant gastroduodenal obstruction, improving markedly the survival qualitv of the patients.

关 键 词：胃出口梗阻 十二指肠梗阻 电化学介入术 

分 类 号：R574.51[医药卫生—消化系统]