经胃入路NOTES腹腔探查在不明原因慢性腹痛中的临床应用  

Diagnostic value of transgastric NOTES approach in chronic abdominal pain of unknown cause

作　　者：唐静[1] 薛焱[1] 沈文拥[1] 杨丹[1] 吴涛[1] 卢丹萍[1] 魏沙[1] 刘爱民[1] TANG Jing;XUE Yan;SHEN Wen-yong;YANG Dan;WU Tao;LU Dan-ping;WEI Sha;LIU Ai-min(Department of Gastroenterology,Chongqing Fuling Central Hospital,Chongqing 408000,CHINA)

机构地区：[1]重庆市涪陵中心医院消化科,重庆408000

出　　处：《海南医学》2020年第14期1861-1864,共4页Hainan Medical Journal

基　　金：重庆市涪陵区科技计划项目科研课题(编号:FLKW,2017ABB1045)。

摘　　要：目的探讨经胃入路自然腔道内镜手术(NOTES)诊断不明原因慢性腹痛的临床应用价值。方法回顾性分析重庆市涪陵中心医院消化内镜中心2016年6月至2019年12月收治的36例不明原因慢性腹痛采用经胃NOTES腹腔探查的临床资料,明确该手术的临床价值。结果平均手术时间为(42.65±6.36)min,术中无中转外科病例;明确病因32例(88.9%),其中肠黏连19例(52.8%)、结核性腹膜炎4例(11.1%)、慢性阑尾炎3例(8.3%)、转移性腹膜癌3例(8.3%)、原发性腹膜癌1例(2.8%)、腹膜间皮瘤1例(2.8%)、肝硬化1例(2.8%)、阴性探查4例(11.1%);术后均无严重并发症,术后随访率为100%;其中腹痛完全缓解22例(61.1%),腹痛程度减轻6例(16.7%),总体腹痛缓解有效率为77.8%。结论经胃入路NOTES腹腔探查及腹膜活捡术对慢性腹痛病因诊断具有较高的临床应用价值,值得临床推广。Objective To explore the value of clinical application of transgastric Natural Orifice Transluminal Endoscopic Surgery(NOTES)approach in the diagnosis of chronic abdominal pain of unknown cause.Methods From June 2016 to December 2019,the clinical data of 36 patients with chronic abdominal pain of unknown cause undergoing transgastric NOTES in Digestive Endoscope Center,Chongqing Fuling Central Hospital were retrospectively analyzed to determine clinical value of the operation.Results The average operation time was(42.65±6.36)min,and no patient was converted to laparotomy during the operation.The disease causes were explicit in 32 cases(88.9%),including 19 cases of intestinal adhesions(52.8%),4 cases of tuberculous peritonitis(11.1%),3 cases of chronic appendicitis(8.3%),3 cases of metastatic peritoneal cancer(8.3%),1 case of primary peritoneal cancer(2.8%),1 case of peritoneal mesothelioma(2.8%),and 1 case of cirrhosis(2.8%),4 cases of negative detection(11.1%).There were no serious complications after the operation.The postoperative follow-up rate was 100%.The abdominal pain was completely relieved in 22 cases(61.1%)and relieved in 6 cases(16.7%),and the overall effective rate of abdominal pain relief was 77.8%.Conclusion Abdominal exploration under transgastric NOTES approach and peritoneal biopsy has high clinical application value in the diagnosis of chronic abdominal pain of unknown cause,which is worthy of clinical application.

关 键 词：经胃入路 自然腔道内镜手术 腹腔探查 腹痛 诊断 

分 类 号：R441.1[医药卫生—诊断学]