内镜下钛夹联合氩等离子体凝固治疗食管癌术后吻合口瘘患者的临床效果  

Clinical effect of endoscopic titanium clip combined with argon-plasma coagulation in the treatment of patients with anastomotic fistula after esophageal cancer operation

作　　者：翁艳 王青 刘晓川 金麟 褚云香 王东盛 贾志伟 孙莹 WENG Yan;WANG Qing;LIU Xiaochuan;JIN Lin;CHU Yunxiang;WANG Dongsheng;JIA Zhiwei;SUN Ying(Department of Gastroenterology,Emergency General Hospital,Beijing 100028,China;Department of Geriatrics,Emergency General Hospital,Beijing 100028,China)

机构地区：[1]应急总医院消化内科,北京市100028 [2]应急总医院老年科,北京市100028

出　　处：《广西医学》2023年第6期639-641,665,共4页Guangxi Medical Journal

基　　金：应急总医院医学发展科研基金项目(K201915)。

摘　　要：目的探讨内镜下钛夹联合氩等离子体凝固治疗食管癌术后吻合口瘘患者的临床效果。方法回顾性分析70例食管癌术后吻合口瘘患者的临床资料,按治疗方案将患者分为A组34例与B组36例。A组患者采用常规保守治疗,B组患者在A组的基础上采用内镜下钛夹联合氩等离子体凝固治疗。比较两组患者吻合口瘘愈合时间、开始治疗后的住院时间,治疗2周后的吻合口瘘愈合率,以及治疗前及治疗2周后的血清降钙素原、白细胞介素(IL)-6、IL-8水平。结果B组患者吻合口瘘愈合时间、开始治疗后的住院时间均短于A组,且治疗2周后的吻合口瘘愈合率高于A组(均P<0.05)。治疗2周后,两组患者的血清降钙素原、IL-6、IL-8水平均低于治疗前,且B组上述指标水平均低于A组(均P<0.05)。结论在常规保守治疗的基础上采用内镜下钛夹联合氩等离子体凝固治疗食管癌术后吻合口瘘患者的效果良好,能促进吻合口瘘愈合时间及降低炎症因子水平,从而缩短患者住院时间。Objective To investigate the clinical effect of endoscopic titanium clip combined with argon-plasma coagulation in the treatment of patients with anastomotic fistula after esophageal cancer operation.Methods The clinical data of 70 patients with anastomotic fistula after esophageal cancer operation were retrospectively analyzed,and they were divided into group A(34 cases)or group B(36 cases)according to therapy regimens.Group A was treated with routine conservation therapy,based on which group B was treated with endoscopic titanium clip combined with argon-plasma coagulation.The healing time of anastomotic fistula,length of hospital stay after the beginning of treatment,and 2-week post-treatment healing rate of anastomotic fistula,as well as the pre-and 2-week post-treatment of serum procalcitonin,interleukin(IL)-6,and IL-8 levels in patients were compared between the two groups.Results Patients in group B obtained shorter healing time of anastomotic fistula and length of hospital stay after the beginning of treatment,and a higher 2-week post-treatment healing rate of anastomotic fistula as compared with group A(all P<0.05).After 2 weeks of treatment,the levels of serum procalcitonin,IL-6,and IL-8 in patients of the two groups were lower than those before treatment,and the aforementioned indices of group B were lower than those of group A(all P<0.05).Conclusion On the basis of routine conservation therapy,employing endoscopic titanium clip combined with argon-plasma coagulation in the treatment of patients with anastomotic fistula after esophageal cancer operation exerts a favorable effect,which can promote the healing time of anastomotic fistula and decrease inflammatory factors levels,so as to shorten length of hospital stay in patients.

关 键 词：食管癌术后吻合口瘘 内镜治疗 钛夹 氩等离子体凝固技术 炎症因子 疗效 

分 类 号：R735.1[医药卫生—肿瘤]