结肠途径经内镜肠道植管术的方法学、安全性和用途探讨(含视频)  

Methodology,safety and applications of colonic transendoscopic enteral tubing(with video)

作　　者：龙楚彦 何植 崔伯塔[1] 张婷 温泉 李倩倩[1] 张洁 季国忠[1] 张发明[1] Long Chuyan;He Zhi;Cui Bota;Zhang Ting;Wen Quan;Li Qianqian;Zhang Jie;Ji Guozhong;Zhang Faming(Medical Center for Digestive Diseases,the Second Affiliated Hospital of Nanjing Medical University,Key Lab of Holistic Integrative Enterology,Nanjing Medical University,Nanjing 210011,China)

机构地区：[1]南京医科大学第二附属医院消化医学中心南京医科大学整合肠病学重点实验室,210011

出　　处：《中华消化内镜杂志》2020年第1期28-32,共5页Chinese Journal of Digestive Endoscopy

基　　金：国家自然科学基金(81670495,81600417);江苏省十三五科教强卫工程创新团队;江苏省六个一工程项目(LGY201708);江苏省重点研发计划(BE2018751)。

摘　　要：目的评价结肠途径经内镜肠道植管术(transendoscopic enteral tubing,TET)作为一种全新的粪菌移植(fecal microbiota transplantation,FMT)和结肠给药途径的方法学、安全性及临床用途。方法纳入2014年10月至2018年12月于南京医科大学第二附属医院接受结肠途径TET用于FMT和(或)结肠给药的全部患者。就TET操作用时、成功率、TET管保留时间、影响TET管保留的因素、不良事件及患者满意度进行分析。结果共257例患者接受结肠TET,其中130例(50.6%)用于菌群移植,8例(3.1%)用于结肠给药,118例(45.9%)用于FMT联合结肠给药,1例(0.4%)植管后未完成治疗。植管操作用时(10.0±2.8)min,使用组织夹(3.5±1.0)枚,植管操作成功率100.0%(257/257)。以维持保留TET管为治疗目的的160例患者TET管保留时间(9.3±3.8)do多变量分析表明组织夹类型是影响TET管保留时间的独立因素(P=0.001)。TET后9例(3.5%)诉轻度肛门不适,4例(1.6%)行动不便,3例(1.2%)肛门疼痛,2例(0.8%)轻度腹痛,2例(0.8%)轻度腹胀,1例(0.4%)少量肛门出血,无严重不良事件。患者对结肠TET满意度为97.3%(250/257)。结论结肠TET是一种安全、操作简单、患者满意度高的介入内镜新技术,可用于多种疾病的全结肠途径菌群移植和药物治疗。ObjectiveTo evaluate the methodology,safety and clinical applications of colonic transendoscopic enteral tubing(TET)as a new method of fecal microbiota transplantation(FMT)and colonic administration.MethodsThis prospective study included patients who underwent colonic TET for FMT and(or)colonic administration in the Second Affiliated Hospital of Nanjing Medical University from October 2014 to December 2018.The TET procedure time,success rate,retention time of TET tube,factors influencing TET tube retention,adverse events and satisfaction degree were evaluated.ResultsA total of 257 patients underwent TET,among whom 130 patients(50.6%)for microbiota tronsplantation,8 patients(3.1%)for colon-drip medication,118 patients(45.9%)for FMT and colon-drip medication,and 1 patient(0.4%)without treatment after TET.The TET procedure time was 10.0±2.8 min.The number of endoscopic clips used was 3.5±1.0.The success rate of the TET procedure was 100.0%(257/257).The retention time of TET tube for 160 patients maintaining the tube for treatment was 9.3±3.8 days.Multivariate analysis indicated that endoscopic clip type(P=0.001)was an independent influencing factor for the retention time of the tube.A total of 9 patients(3.5%)reported adverse events of mild anus discomfort,4 patients(1.6%)of mobile inconvenience,3(1.2%)of anal pain,2(0.8%)of mild abdominal pain,2(0.8%)of mild bloating,and 1(0.4%)of mild anal bleeding.No severe adverse events were observed in this study.The total satisfaction degree on colonic TET was 97.3%(250/257)in all patients.ConclusionThe colonic TET,a safe and easy-operating endoscopic interventional technology with a high degree of patients satisfaction,can be used for colonic delivering of FMT and medications for various diseases.

关 键 词：结肠镜检査 粪菌移植 灌肠 经内镜肠道植管术 

分 类 号：R656[医药卫生—外科学]