内镜超声治疗胰腺假性囊肿内引流支架的选择  

Stent selection of endoscopic ultrasound-guided transgastric drainage for pancreatic pseudocysts

作　　者：王正峰[1] 陈浩斐 盛亮 何英丽 王芳昭 张磊[1] 周文策[2] Wang Zhengfeng;Chen Haofei;Sheng Liang;He Yingli;Wang Fangzhao;Zhang Lei;Zhou Wence(Department of General Surgery,The First Hospital of Lanzhou University,Lanzhou 730000,China;The First Clinical Medical College of Lanzhou University,Lanzhou 730000,China;Surgical Endoscopic Center,The First Hospital of Lanzhou University,Lanzhou 730000,China)

机构地区：[1]兰州大学第一医院普外科,兰州730000 [2]兰州大学第一临床医学院,兰州730000 [3]兰州大学第一医院外科内镜中心,兰州730000

出　　处：《中华消化内镜杂志》2022年第8期641-644,共4页Chinese Journal of Digestive Endoscopy

基　　金：甘肃省自然科学基金(21JRIRA113,20JR10RA692);兰州市人才创新创业项目(2020⁃RC⁃46)。

摘　　要：目的探讨内镜超声(endoscopic ultrasound,EUS)引导下经胃内引流术治疗胰腺假性囊肿时,不同型号塑料支架的引流效果。方法对兰州大学第一医院外科内镜中心2014年3月—2020年12月所施行的EUS引导下经胃内引流治疗胰腺假性囊肿患者的相关临床资料进行回顾性分析,将患者分为置入“双猪尾”10 F双塑料支架组和置入“双猪尾”7 F双塑料支架组,比较这两组塑料支架的引流效果、并发症及远期疗效。结果共纳入29例胰腺假性囊肿患者,其中10 F双塑料支架组11例,7 F双塑料支架组18例,两组手术操作时间分别为(48.2±8.0)min及(34.7±5.8)min,差异有统计学意义(t=5.24,P<0.001)。术后腹痛[18.2%(2/11)比5.6%(1/18)]、发热[9.1%(1/11)比11.1%(2/18)]及出血(均无)等并发症发生率,两组间对比差异均无统计学意义(P均>0.05)。2个月后复查CT,10 F双塑料支架组、7 F双塑料支架组嚢腔完全消失率分别为90.9%(10/11)和88.9%(16/18),两组差异无统计学意义(P=1.00)。结论对于符合EUS引导下经胃内引流术治疗胰腺假性囊肿标准的患者,7 F与10 F支架的引流效果及并发症发生率相当,但7 F支架具有手术操作便利、时间较短的优点,值得临床推广。Objective To investigate the drainage efficacy of different types of plastic stents in endoscopic ultrasound(EUS)-guided transgastric drainage for pancreatic pseudocysts.Methods Clinical data of patients with pancreatic pseudocyst who underwent EUS-guided transgastric drainage in the surgical endoscopic center of the First Hospital of Lanzhou University from March 2014 to December 2020 were retrospectively analyzed.Patients were divided into the 10 F double plastic stents group and the 7 F double plastic stents group.The drainage efficacy,complications and long-term outcomes of the two groups were compared.Results A total of 29 patients were included,11 in the 10 F double plastic stents group and 18 others in the 7 F double plastic stents group.The operation time of the two groups was 48.2±8.0 min and 34.7±5.8 min,respectively,showing significant difference(t=5.24,P<0.001).There was no significant difference in the incidence of postoperative complications such as abdominal pain[18.2%(2/11)VS 5.6%(1/18)],fever[9.1%(1/11)VS 11.1%(2/18)]or bleeding(both none)between the two groups(all P>0.05).Two months after the operation,abdominal CT scan showed that the complete disappearance rates of cysts cavity in the 10 F and 7 F groups were 90.9%(10/11)and 88.9%(16/18),respectively,with no significant difference(P=1.00).Conclusion There are similar drainage effect and postoperative complications rates between the 7 F and the 10 F plastic stent in EUS-guided transgastric drainage for pancreatic pseudocysts.However,operation with the 7 F stent is more convenient for a shorter time,which is worth of clinical promotion.

关 键 词：胰腺假囊肿 腔内超声检查 引流 支架 

分 类 号：R657.52[医药卫生—外科学]