经内镜OTSC吻合夹闭合消化道瘘的临床研究  

Clinical study on endoscopic closure of gastrointestinal fistula using the over-the-scope-clip system

作　　者：张娟娟[1] 汪志明[1] 刁艳青[1] 张永良[1] 王革非[1] ZHANG Juan-juan;WANG Zhi-ming;DIAO Yan-qing;ZHANG Yong-liang;WANG Ge-fei(Department of General Surgery,Nanjing General Hospital of Nanjing Military Region,PLA,Nanjing 210002,Jiangsu,China)

机构地区：[1]南京军区南京总医院全军普通外科研究所,南京医学硕士210002

出　　处：《医学研究生学报》2018年第10期1054-1056,共3页Journal of Medical Postgraduates

基　　金：江苏省社会发展面上项目(BE2017725)

摘　　要：目的消化道瘘是严重的术后并发症,而OTSC吻合夹能闭合消化道全层,有效治疗消化道瘘。文中旨在观察经内镜OTSC吻合夹闭合消化道瘘的疗效。方法回顾性分析2014年10月至2017年10月南京军区南京总医院全军普通外科研究所内镜中心进行内镜下OTSC吻合夹闭合治疗的28例术后消化道瘘患者临床资料。统计患者病程、消化道瘘的部位、瘘口直径等及OTSC夹闭后疗效。OTSC治疗成功者出院后门诊随诊半年,观察有无消化道瘘。结果 28患者OTSC吻合夹均夹闭成功,无脱落、出血等并发症。OTSC夹闭后1～2周行窦道或者消化道造影检查,23例(82.14%)消化道瘘愈合。23例治疗成功患者出院后随访半年,其中4例患者失访,19例患者随访期间未再出现消化道瘘。结论 OTSC吻合夹治疗消化道瘘安全有效,避免再次手术,减少创伤。Objective Gastrointestinal fistula is a serious complication after operation.It is reported that the over-the-scope-clip(OTSC)can close intestinal full-thickness wall and treat gastrointestinal fistula effectively.This study was to investigate the efficacy of OTSC in the treatment of gastrointestinal fistula. Methods We analyzed the clinical data of 28 postoperative patients with gastrointestinal fistula who underwent endoscopic closure using OTSC in Endoscopy Center of Research Institute of General Surgery in our hospital from October 2014 to October 2017,and recorded the course of disease,the site of gastrointestinal fistula,the diameter of fistula and the efficacy of OTSC.Patients with successful closure were followed up for half a year after hospital discharge to observe the recurrence of fistula. Results Endoscopic closure with OTSC was successful in all the 28 patients without complications like bleeding and falling off.In the sinus tract or digestive tract radiography at 1-2 weeks after OTSC closure,23 patients were successful in endoscopic closure(82.14%).In the six months′follow-up of 23 patients with successful treatment,4 patients were lost to follow-up and 19 patients were successful without recurrence of fistula. Conclusion The endoscopic closure of gastrointestinal fistula using OTSC is safe and effective,avoiding reoperation and reducing trauma.

关 键 词：OTSC吻合夹 内镜治疗 消化道瘘 

分 类 号：R57[医药卫生—消化系统]