腹腔穿刺放气结合胃肠减压在内镜下胃全层切除术后的应用  

The application of abdominocentesis and gastrointestinal decompression during the endoscopic full-thick-ness resection for gastric submucosal tumors

作　　者：周静芳[1] 戴伟杰[1] 陶国全[2] 王琼[1] 杨晓钟[1] 

机构地区：[1]南京医科大学附属淮安第一医院消化科,江苏南京223300 [2]南京医科大学附属淮安第一医院胃肠外科,江苏南京223300

出　　处：《中国医学装备》2015年第8期7-10,共4页China Medical Equipment

基　　金：国家自然科学基金(81302490)"PI3K/Akt/m TOR信号通路基因遗传变异与胃癌易感及其机制研究"

摘　　要：目的:探讨腹腔穿刺放气结合胃肠减压在胃黏膜下肿瘤(SMT)行内镜全层切除术(EFR)后伴发气腹中的应用。方法:选取15例行EFR治疗的SMT患者,术后常规进行腹腔穿刺放气并放置胃肠减压管,对所有病例从病灶大小、起源部位、穿孔直径、气腹量以及术后恢复时间等方面进行系统分析。结果:15例患者中1例因穿孔直径过大未能在内镜下缝合,转腹腔镜腔外缝合,其余均在内镜下成功缝合,平均肿瘤大小为(2.0±0.5)cm,平均手术时间为(84.9±8.9)min,穿孔平均直径为(0.8±0.4)cm,缝合所需钛夹平均为(4.5±1.9)枚,术后腹部立位片右侧膈下游离气体深度平均值为(6.2±3.3)cm,术后平均进食时间为(4.1±1.5)d,术后平均住院天数为(6.4±3.5)d,术后随访气腹完全吸收时间为(12.6±5.1)d。结论:腹腔穿刺放气结合胃肠减压是一种安全有效的处理胃黏膜下肿瘤行EFR术后伴发气腹的有效方法。Objective： To summarize the application of abdominocentesis and gastrointestinal decompression during the endoscopic full-thick-ness resection for gastric submucosal tumors. Methods： There were 15 gastric SMTs were treated by EFR, we summarized the researches from the tumor size, the tumor origin, the diameter of perforation, the pneumoperitoneum and the recoverv period, et al. Results： One of them failed to suture because the perforation size was 7 too-large, the median tumor size was 2.0±0.5cm, the median operation time was 84.9±8.9min, the median diameter of perforation was 0.8±0.4cm, the median hemostatic clips was 4.5±1.9, the median recovery period was 6.4±3.5 days, decompression is safe and effective method to deal with pneumoperitoneum after the EFR for gastric SMT

关 键 词：胃黏膜下肿瘤 内镜下全层切除术 腹腔穿刺 胃肠减压 

分 类 号：R656.61[医药卫生—外科学]