十二指肠嵌顿性异物37例的胃镜诊治分析  

Analysis of gastroscopic diagnosis and treatment in 37 cases of incarcerated foreign bodies at duodenum

作　　者：杨卓[1] 张丽瑶[2] 赵云峰[1] 张迎春[1] 高峰[1] 麻树人[1] 张宁[1] 宫照杰[1] 

机构地区：[1]沈阳军区总医院内窥镜科,辽宁省消化疾病微创治疗研究所,110016 [2]沈阳市第六人民医院重症监护病房

出　　处：《中华消化杂志》2015年第1期30-33,共4页Chinese Journal of Digestion

摘　　要：目的 探讨不同性质的十二指肠嵌顿性异物经胃镜诊断和治疗的可行性,及其临床疗效和安全性.方法 纳入2005年1月至2013年12月病历资料完整的37例十二指肠嵌顿性异物患者,回顾性分析经胃镜取出异物的成功率、异物嵌顿的部位、异物的种类和长度,以及并发症等相关情况.结果 37例十二指肠嵌顿性异物患者中,经胃镜安全取出异物35例,转外科手术2例,胃镜治疗成功率为94.6％;异物嵌顿于十二指肠球部8例,十二指肠降部16例,十二指肠水平部8例,十二指肠升部5例;透壁性异物9例.异物种类包括牙签1例,圆珠笔3例,塑料匙2例,挖耳匙1例,牙刷7例,食物团块6例,鸡骨2例,木签（近40枚）1例,带金属钩义齿3例,铁丝3例,玻璃片1例,铁钉5例,刀片2例.胃镜诊治中和诊治后均无大量出血、穿孔等并发症发生.结论 十二指肠嵌顿性异物可经胃镜明确诊断和治疗,其可操作性强、创伤小、并发症少、疗效确切,绝大部分能避免外科手术,是诊治十二指肠嵌顿性异物安全、有效的措施.Objective To evaluate the therapeutic approach,feasibility,efficacy and safety of endoscopic diagnosis and therapy in different incarcerated foreign bodies at duodenum.Methods From January 2005 to December 2013,37 patients with incarcerated foreign bodies at duodenum and with complete clinical data were enrolled.The successful rate of foreign bodies removed by gastroscope,the location,type and length of the foreign bodies,and the complications of the 37 patients were retrospectively analyzed.Results Among 37 patients with incarcerated foreign bodies at duodenum,the foreign bodies of 35 cases were successfully removed by gastroscope and the other two were transferred to surgery department for operation,and the successful rate of gastroscopic treatment was 94.6%.Eight cases with incarcerated foreign bodies were at duodenal bulb,16 cases at descendent duodenum,eight cases at horizontal portion of the duodenum and five cases at ascending portion of the duodenum.Nine cases were penetrating foreign bodies.The types of foreign bodies included toothpicks （one case）,ball-point pens （three cases）,plastics spoons （two cases）,earpick （one case）,toothbrushes （seven cases）,food blocks （six cases）,chicken bones （two cases）,pegwoods （about 40 pieces,one case）,dentures with hook （three cases）,iron wires （three cases）,glass plate （one case）,iron nails （five cases） and razor blades （two cases）.There were no complications such as bleeding and perforation during and after endoscopic diagnosis and therapy.Conclusions The incarcerated foreign bodies at duodenum could be diagnosed and treated by endoscope with the andvantage of easy handling,little injury,less complication,exact curative effect and less need for surgery.It is an effective approach to the diagnosis and treatment of incarcerated foreign bodies at duodenum.

关 键 词：十二指肠 异物 内镜 治疗 

分 类 号：R574[医药卫生—消化系统]