内镜吻合夹在治疗重症急性胰腺炎合并消化道瘘中的应用  

Application of over-the -scope clip system in the treatment of severe acute pancreatitis complicated with gastrointestinal fistula

作　　者：达彬琳 汪立新 汪志明[1] 张娟娟[1] 王晓玮 朱楠[1] 朱琳[1] 刁艳青[1] DA Bin-lin;WANG Li-xin;WANG Zhi-ming;ZHANG Juan-juan;WANG Xiao-wei;ZHU Nan;ZHU Lin;DIAO Yan-qing(Department of General Surgery,General Hospital of Eastern Theater Command,PLA,Nanjing 210002,Jiangsu,China;Department of Radiotherapy,Air Force Hospital of Eastern Theater Command,Nanjing 210002,Jiangsu,China)

机构地区：[1]东部战区总医院(原南京军区南京总医院)全军普通外科研究所,南京210002 [2]东部战区空军医院放疗科,南京210002

出　　处：《医学研究生学报》2021年第6期625-628,共4页Journal of Medical Postgraduates

摘　　要：目的目前国内外对于重症急性胰腺炎(SAP)合并消化道瘘患者应用OTSC吻合夹的临床研究较少。文中旨在探讨内镜吻合夹(OTSC)在SAP合并消化道瘘治疗中的疗效。方法回顾性分析2012年1月至2020年12月东部战区总医院普通外科内镜中心19例行经内镜OTSC吻合夹夹闭SAP合并消化道瘘患者的临床资料。统计分析患者的基本临床资料及OTSC吻合夹对SAP合并消化道瘘患者的临床疗效。结果患者中占比最多的是结肠瘘8例(42.11%),其次是十二指肠瘘7例(36.84%),胃瘘4例(21.05%)。消化道瘘发生的时间在SAP确诊后平均(11.53±5.12)周,瘘口直径平均为(7.05±2.14)mm。所有患者均OTSC吻合夹夹闭成功,术中及术后未出现内镜相关并发症。OTSC成功释放的时间为(25.00±11.20)min。患者总体临床治愈率为68.42%(13/19)。结论OTSC吻合夹治疗SAP合并消化道瘘患者操作时间短,安全性好,治愈率高,是一种易于开展、安全、有效的治疗方式。Objective There are few clinical studies on the application of over-the-scope clips,OTSC in patients with severe acute pancreatitis(SAP)complicated with gastrointestinal fistula at home and abroad.The purpose of this study was to investigate the efficacy of OTSC in the treatment of SAP combined with gastrointestinal fistula.Methods The clinical data of 19 patients with SAP combined with gastrointestinal fistula who underwent OTSC were retrospectively analyzed from January 2012 to December 2020 in the General Surgery Enendoscopy Center of the Eastern Theater General Hospital.The basic clinical data of the patients and the clinical effect of OTSC on patients with SAP complicated gastrointestinal fistula were analyzed statistically.Results Colonic fistula accounted for the most in 8 cases(42.11%),duodenal fistula in 7 cases(36.84%)and gastric fistula in 4 cases(21.05%).The average time of gastrointestinal fistula was(11.53±5.12)weeks after SAP diagnosis,and the average diameter of fistula was(7.05±2.14)mm.All patients were successfully clipped with OTSC,and no endoscope-related complications occurred during and after the operation.The successful release time of OTSC was(25.00±11.20)min.The overall clinical cure rate was 68.42%(13/19).Conclusion OTSC system is an easy,safe and effective treatment for patients with gastrointestinal fistula complicated by SAP,with short operation time,good safety and high cure rate.

关 键 词：急性重症胰腺炎 消化道瘘 内镜吻合夹 

分 类 号：R576[医药卫生—消化系统]