内镜超声引导下新型管腔金属支架治疗感染性胰腺坏死的临床应用初探(含视频)  

Clinical application of endoscopic ultrasound-guided new luminal metal stent placement for infected pancreatic necrosis(with video)

作　　者：张超 沈红璋 杨建锋 金杭斌 楼奇峰 张筱凤 Zhang Chao;Shen Hongzhang;Yang Jianfeng;Jin Hangbin;Lou Qifeng;Zhang Xiaofeng(The Fourth Clinical Medicine School,Zhejiang Chinese Medical University,Hangzhou 310006,China;Department of Gastroenterology,Affiliated Hangzhou First People's Hospital,Zhejiang University School of Medicine Hangzhou Institute of Digestive Diseases Key Laboratory of Integrated Traditional Chinese and Western Medicine for Biliary and Pancreatic Diseases of Zhejiang Province,Hangzhou 310006,China)

机构地区：[1]浙江中医药大学第四临床医学院,杭州310006 [2]浙江大学医学院附属杭州市第一人民医院消化内科,杭州市消化病研究所,浙江省中西医结合胆胰疾病重点实验室,杭州310006

出　　处：《中华消化内镜杂志》2022年第10期833-837,共5页Chinese Journal of Digestive Endoscopy

基　　金：浙江省卫生健康重大科技计划(WKJ-ZJ-2136);浙江省医药卫生科技计划(2018PY037);杭州市农业与社会发展科研重点项目(202004A14);杭州市医药卫生科技项目(OO20190610,A20200174)。

摘　　要：为了评估内镜超声引导下带有烧灼系统的新型管腔金属支架——Hot AXIOS治疗感染性胰腺坏死(infected pancreatic necrosis,IPN)的临床疗效和安全性,对2021年12月—2022年1月杭州市第一人民医院行内镜超声引导下Hot AXIOS治疗的总共5例IPN病例进行了回顾性分析,结果显示:5例均成功完成治疗,用时8~21 min;术后第1天腹痛、腹胀症状均明显缓解,复查腹部CT提示包裹性坏死均明显缩小,后续成功施行2~9次直接内镜下坏死组织清除术治疗,辅以抗生素治疗后,体温趋于正常、血炎症指标基本正常、坏死腔缩小、坏死物清除干净,Hot AXIOS支架留置12~40 d后拔除;出院后随访25~113 d,所有患者存活且未复发。初步结果提示,内镜超声引导下Hot AXIOS治疗IPN安全、有效。To evaluate the clinical efficacy and safety of Hot AXIOS,a novel luminal metal stent with a cautery system guided by endoscopic ultrasound,for the treatment of infected pancreatic necrosis(IPN),5 cases of IPN treated with endoscopic ultrasound-guided Hot AXIOS placement in Hangzhou First People's Hospital from December 2021 to January 2022 were retrospectively analyzed.The results showed that all 5 cases successfully completed the treatment,with 8-21 minutes of the operation time.The symptoms of abdominal pain and bloating on the first day after operation were significantly relieved,and the abdominal CT showed that the walled-off necrosis was significantly reduced.After 2-9 times of direct endoscopic necrosectomy,supplemented by antibiotics,patient's temperature and blood inflammatory indexes returned to normal,the cavity was reduced and necrosis was removed.The Hot AXIOS stent was indwelled for 12-40 days and then removed.After 25-113 days of the follow-up,all patients survived without recurrence.Preliminary results suggest that endoscopic ultrasound-guided Hot AXIOS placement is safe and effective for the treatment of IPN.

关 键 词：胰腺疾病 感染性胰腺坏死 超声内镜 支架 引流 清创 

分 类 号：R576[医药卫生—消化系统]