急诊内镜下钛夹缝合治疗直肠穿孔1例  

Treatment of rectal perforation with titanium splint under emergency endoscope:a case report

作　　者：段香梅 罗萍 况晶 刘锦飞 沈文拥 DUAN Xiangmei;LUO Ping;KUANG Jing;LIU Jinfei;SHEN Wenyong(Clinical Medicine,North Sichuan Medical College,Nanchong,Sichuan,637000,China;Department of Gastroenterology,Chongqing University Fuling Hospital)

机构地区：[1]川北医学院临床医学院,四川南充637000 [2]重庆大学附属涪陵医院消化内科

出　　处：《临床急诊杂志》2022年第9期674-676,共3页Journal of Clinical Emergency

基　　金：重庆市卫生健康委员会资助项目(No:2019jstg007)。

摘　　要：回顾性分析重庆大学附属涪陵医院收治的1例自发性直肠穿孔老年患者的临床资料,并进行总结分析。患者因间断血便伴腹痛收治入院,既往有冠状动脉粥样硬化性心脏病、快速性心房纤颤、多发脑梗死、慢性阻塞性肺疾病等病史。入院时患者发热,下腹部压痛、反跳痛,急诊内镜检查诊断直肠穿孔伴出血。经多学科评估后,予以急诊内镜下钛夹缝合治疗,治疗过程中变换体位使瘘口处于高位,充分冲洗瘘口后,钛夹夹闭瘘口成功,后经消炎治疗8 d,治愈出院。To study the diagnosis and treatment of spontaneous rectal perforation.To retrospectively analyze and summarize the clinical data of an elderly patient with spontaneous rectal perforation in Chongqing University Fuling Hospital.The patient was admitted with intermittent bloody stools and abdominal pain,and had a history of coronary arteriosclerosis,rapid atrial fibrillation,multiple cerebral infarction,and chronic obstructive pulmonary disease.Fever,tenderness and rebound pain in the lower abdomen were present on admission.Emergency endoscopy was performed to diagnose rectal perforation with bleeding.After multi-disciplinary evaluation,change the position of the fistula under emergency endoscopy to make it in a high position.After flushing the fistula,the fistula was successfully clamped with titanium clips.After 8 days of anti-inflammatory treatment,the patient was cured and discharged.

关 键 词：直肠穿孔 内镜治疗 钛夹 

分 类 号：R574[医药卫生—消化系统]