内镜结合X线下十二指肠金属支架植入体会并附15例临床分析  

Operational experience of duodenal metal stent implantation under endoscopy combined with X-ray,attaching with clinical analysis of 15 cases

作　　者：赵刚[1] 宋亚华[1] 安苗[1] 万晓龙[1] 戴社教[1] 王进海[1] 董蕾[1] 陈芬荣[1] ZHAO Gang;SONG Yahua;AN Miao;WAN Xiaolong;DAI Shejiao;WANG Jinhai;DONG Lei;CHEN Fenrong(Department of Gastroenterology,the Second Affiliated Hospital of Xi’an Jiaotong University,Xi’an 710004,China)

机构地区：[1]西安交通大学第二附属医院消化内科

出　　处：《胃肠病学和肝病学杂志》2020年第2期178-182,共5页Chinese Journal of Gastroenterology and Hepatology

基　　金：陕西省自然科学基金资助项目(2012JQ4030)

摘　　要：目的评估内镜结合X线下对恶性十二指肠梗阻患者实施金属支架植入术的疗效及安全性。方法收集2016年3月至2019年6月在我院消化内科接受内镜结合X线下十二指肠金属支架植入术的全部15例患者的各项临床资料,同时记录并分析其接受内镜结合X线下的治疗情况、内镜下操作时间、X线暴露时间、术后梗阻改善情况及并发症发生情况等。结果所有接受内镜结合X线下十二指肠金属支架植入术的15例患者,除1例因十二指肠狭窄程度严重,反复尝试后导丝及导管无法通过狭窄段外,其余14例均成功植入十二指肠金属支架,操作时间22~67 min,平均操作时间37.53 min,X线暴露时间108~272 s,平均X线暴露时间142 s。14例手术成功患者术后恶心及呕吐症状基本消失,进食状况均较前明显改善。全部15例患者术后均无出血、穿孔及发热等并发症出现。结论内镜结合X线下十二指肠金属支架植入是针对恶性十二指肠梗阻且无外科手术机会患者的一种安全有效的内镜下治疗措施,值得进一步推广应用。Objective To evaluate the efficacy and safety of metal stent implantation in patients with malignant duodenal obstruction under endoscopy combined with X-ray. Methods From Mar. 2016 to Jun. 2019,clinical data of 15 patients who underwent endoscopy combined with X-ray duodenal metal stent implantation in the Department of Gastroenterology were collected. The condition of treatment,operating time,X-ray exposure time,improvement of obstruction after operation and complications were recorded for a clinical analysis. Results All 15 patients underwent duodenal metal stent implantation under endoscopy combined with X-ray. Except 1 patient who had severe duodenal stenosis and could not pass through the stenosis segment after repeated attempts,the other 14 patients were successfully implanted with duodenal metal stent. The operation time was 22-67 minutes,the average operation time was 37.53 minutes,and the X-ray exposure time was 108-272 seconds,and the average time of X-ray exposure was 142 seconds. The symptoms of nausea and vomiting disappeared in 14 patients after successful operation,and the eating condition improved significantly. No complications such as bleeding, perforation and fever occurred in all 15 patients after operation.Conclusion Endoscopy combined with X-ray duodenal metal stent implantation is a safe and effective endoscopic treatment for patients with unresectable malignant duodenal obstruction,which is worthy of further promotion and application.

关 键 词：X射线 十二指肠梗阻 金属支架 内镜治疗 

分 类 号：R574[医药卫生—消化系统]