内镜下切开术治疗原发性克罗恩病肛管直肠狭窄的初步探讨  

Preliminary study of endoscopic stricturotomy in treatment of primary anorectal strictures of Crohn's disease

作　　者：王震龙 周致圆[1] 姚丹华 郑磊[1] 刘斌[1] 段衍涛 姜一帆 庞莉雯 李幼生[1] Zhen-longWang;Zhi-yuan Zhou;Dan-hua Yao;Lei Zheng;Bin Liu;Yan-tao Duan;Yi-fan Jiang;Li-wen Pang;You-sheng Li(Department of General Surgery,the Ninth People's Hospital,School of Medicine,Shanghai Jiaotong University,Shanghai 200011,China)

机构地区：[1]上海交通大学医学院附属第九人民医院普通外科,上海200011

出　　处：《中国内镜杂志》2021年第2期83-86,共4页China Journal of Endoscopy

基　　金：浦东新区卫生和计划生育委员会卫生计生科研项目(No:PW2018D-01);上海市自然科学基金项目(No:19ZR1429700);上海交通大学医学院附属第九人民医院临床研究型MDT项目(No:201701008);上海交通大学医学院附属第九人民医院临床研究助力计划(No:JYLJ022)。

摘　　要：目的评价内镜下切开术(ES)治疗原发性克罗恩病肛管直肠狭窄的临床疗效。方法回顾性分析2018年9月-2019年12月在该院接受ES治疗的原发性克罗恩病肛管直肠狭窄患者的临床资料。结果13例患者共接受22次ES治疗,人均治疗次数(1.7±0.6)次,狭窄长度0.5~10.0 cm,中位数1.5 cm,狭窄直径0.2~0.8 cm,中位数0.4 cm,即时手术成功率100.0%。随访期内,6例ES前未行近端肠管造口术的患者不需要常规手术干预,7例ES治疗前曾行近端肠管造口术的患者3例已经完成造口还纳手术;所有接受ES治疗的患者未出现并发症。结论ES治疗原发性克罗恩病肛管直肠狭窄安全、有效。Objective To investigate the feasibility and safety of endoscopic stricturotomy(ES)in treatment of primary anorectal strictures of Crohn's disease.Methods The clinical data of 13 patients of prime anorectal strictures of Crohn's disease,who received ES from September 2018 to December 2019 was analyzed retrospectively.Results 13 patients were included in this study.The median length of the treated strictures was 1.50 cm(ranged from 0.5 to 10.0 cm),and the median diameter of the strictures was 0.4 cm(ranged from 0.2 to 0.8 cm).The immediate success with passage of the scope through the stricture after ES therapy was achieved in all these patients.During the followup,none of the 6 patients without stoma required stricture-related surgery.22 ES procedures were successfully performed with no adverse events occurred.Conclusion ES is effective and safe for treating the primary anorectal strictures of Crohn's disease.

关 键 词：克罗恩病 肛周病变 肛管直肠狭窄 内镜治疗 内镜下切开术 

分 类 号：R574[医药卫生—消化系统]