超声内镜引导下支架引流术治疗感染性胰腺坏死的应用研究  

Application of ultrasound endoscopy-guided stent drainage in the treatment of infected pancreatic necrosis

作　　者：贾青青 杨健[1] 张俊文[1] JIA Qingqing;YANG Jian;ZHANG Junwen(Department of Gastroenterology,the First Affiliated Hospital of Chongqing Medical University,Chongqing 400016,China)

机构地区：[1]重庆医科大学附属第一医院消化内科,重庆400016

出　　处：《现代医药卫生》2023年第21期3681-3684,共4页Journal of Modern Medicine & Health

摘　　要：目的分析超声内镜引导下支架引流术治疗感染性胰腺坏死(IPN)的临床疗效及安全性。方法回顾性分析2018年11月至2021年11月该院收治的36例采用超声内镜引导下穿刺引流术治疗的IPN患者的技术成功率、临床成功率、并发症发生率、非计划再次内镜手术操作率及复发率,并对如何减少术后并发症发生率进行探讨。失访1例,患者出院后未返回该院继续诊治或随访。结果36例患者采用超声内镜引导下支架引流术治疗IPN的技术成功率为100.0%(36/36)。治疗失败1例,最终予以经皮穿刺引流后好转。临床成功率为97.1%(34/35),非计划再次内镜手术操作率为25.7%(9/35),复发率为5.7%(2/35)。术后9例患者出现感染,1例患者发生不完全性肠梗阻,并发症发生率为27.8%(10/36),无术后出血、穿孔及死亡病例。结论超声内镜引导下的支架引流术是一种安全、有效的IPN的内镜治疗方法,值得进一步推广应用。Objective To analyze the efficacy and safety of ultrasound endoscopic treatment of infected pancreatic necrosis(IPN).Methods The technical success rate,clinical success rate,complication rate,unplanned re-endoscopic operation rate and recurrence rate of 36 patients with IPN treated by endoscopy-guided puncture and drainage in this unit from November 2018 to November 2021,and how to reduce the postoperative complication rate was discussed.One patient was lost to follow-up,and the patient did not return to the hospital for further treatment or follow-up after discharge.Results The technical success rate of 36 patients with IPN treated by endoscopic stent drainage was 100.0%(36/36).One case failed in treatment,and finally got better after percutaneous drainage.The clinical success rate was 97.1%(34/35),the operation rate of unplanned reoperation was 25.7%(9/35),and the recurrence rate was 5.7%(2/35).Postoperative infection occurred in 9 patients,and incomplete intestinal obstruction occurred in one patient.The incidence of complications was 27.8%(10/36),and there were no postoperative bleeding,perforation and death.Conclusion Ultrasound endoscopy-guided stent drainage is a safe and effective endoscopic treatment for IPN,which is worth further popularization and application.

关 键 词：感染性胰腺坏死 超声内镜 支架 引流术 治疗结果 安全 

分 类 号：R576[医药卫生—消化系统]