结肠镜下息肉高频电切术并发肠穿孔的原因分析与对策  

作　　者：曹泮悬 周继勇[1] 沈永洲[1] 

机构地区：[1]浙江省海宁市中医院,314400

出　　处：《浙江临床医学》2017年第12期2242-2244,共3页Zhejiang Clinical Medical Journal

基　　金：公共卫生中央财政转移支付项目（卫疾控非传便函[2005]151号）

摘　　要：目的分析和探讨结肠镜下息肉电切治疗发生肠穿孔的原因，为预防和减少肠穿孔并发症的发生几率提供参考。方法基于结直肠癌早诊早治筛查项目，对肠镜下息肉高频电切治疗病例发生肠穿孔并发症原因进行分析。结果自2007年7月至2016年6月期间，肠镜下息肉电切治疗5523例，发生肠穿孔12例（0．22％），其中男7例，女5例；年龄44-70岁，平均年龄60．2岁。最大息肉3．0cm，最小0．5cm。视肠穿孔发生的具体状况，分别采取了不同的治疗措施，包括：保守治疗5例，肠镜下钛夹缝合修补1例，腔镜下缝合修补2例，双镜联合下修补1例，开腹肠穿孔缝合修补3例，全部病例均成功治愈，无死亡病例。结论严格掌握治疗适应证及禁忌证，肠镜下息肉电切技术精准是关键，一旦发现肠穿孔，快速、准确、合理治疗尤为重要。Objective To investigate the causes of intestinal perforation in endoscopic polypectomy of polyps and to provide reference for early diagnosis of colorectal cancer. Methods Based on the screening program for early treatment to prevent and reduce the incidence of complications of intestinal perforation,endoscopic polypectomy of polyps in the treamaent of cases of intestinal perforation complications were analyzed.Results From July 2007 to June2016, the polyp endoscopic resection in the treatment of 5523 cases of intestinal perforation occurred in 12 cases （ 0.22% ） , of which： 7 cases were male,5 female age 44~70 years old, average age was 60.2. The largest polyp was 3.0cm, the smallest was 0.5crn. According to the different conditions of intestinal perforation, different treatment measures were adopted respectively： 5 cases of conservative treatment, endoscopic titanium clip suture repair in 1 cases, laparoscopic suture repair in 2 cases, 1 case was repaired under endoscopy combined with laparotomy, intestinal perforation suture repair in 3 cases, all cases were cured and no death case. Conclusion Treatment to strictly grasp the indications and contraindications, the polyp colonoscopy is the key technology of precision cutting , once found intestinal perforation, rapid, accumte and reasonable trealment is very important.

关 键 词：结肠镜 息肉电切 肠穿孔 原因分析 对策 

分 类 号：R735.05[医药卫生—肿瘤]