医源性胃穿孔中应用内镜下闭合技术的治疗效果与安全性分析
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摘要
目的分析医源性胃穿孔中应用内镜下闭合技术的治疗效果与安全性。方法选取本院2015年11月至2017年11月期间胃黏膜下肿瘤行内镜治疗术,在术中发生胃穿孔后行金属闭合技术的21例患者作为研究对象。分析内镜下金属闭合技术在医源性胃穿孔的治疗效果与安全性。结果本组21例患者均及时有效进行内镜下OTSC闭合,平均留置胃管时间(3.15±1.12)d,平均开放饮食时间(3.65±1.16)d,平均术后住院时间(6.95±1.23)d,平均抗生素应用时间(5.62±1.10)d;闭合手术后出现2例出血,8例发热,6例腹痛;闭合时间10～20 min,平均(16.25±1.63)min。结论内镜下OTSC夹闭系统技术对医源性胃穿孔的疗效肯定,且术后并发症少,安全性好。
Objective To analyze the efficacy and safety of endoscopic closure in iatrogenic gastric perforation. Methods Endoscopic treatment of submucosal tumor of the stomach during the period of November 2015 to November 2017 was selected as the research object of 21 patients undergoing gastric perforation after intraoperative gastric perforation. The therapeutic effect and safety of endoscopic metal closure in iatrogenic gastric perforation were analyzed. Results All the 21 patients in this group were treated with endoscopic OTSC closure in time, the average time of indwelling gastric tube(3.15±1.12) d, open diet time(3.65±1.16) d, average(6.95±1.23) d after operation, and average application time of antibiotics(5.62±1.10) d, 2 cases of hemorrhage, 8 fever and 6 cases after closed hand operation. Abdominal pain; closure time was 10～20 min, with an average of(16.25 ± 1.63) min. Conclusion Endoscopic OTSC clipping system is effective in treating iatrogenic gastric perforation, with fewer postoperative complications and better safety.
Objective To analyze the efficacy and safety of endoscopic closure in iatrogenic gastric perforation. Methods Endoscopic treatment of submucosal tumor of the stomach during the period of November 2015 to November 2017 was selected as the research object of 21 patients undergoing gastric perforation after intraoperative gastric perforation. The therapeutic effect and safety of endoscopic metal closure in iatrogenic gastric perforation were analyzed. Results All the 21 patients in this group were treated with endoscopic OTSC closure in time, the average time of indwelling gastric tube(3.15±1.12) d, open diet time(3.65±1.16) d, average(6.95±1.23) d after operation, and average application time of antibiotics(5.62±1.10) d, 2 cases of hemorrhage, 8 fever and 6 cases after closed hand operation. Abdominal pain; closure time was 10～20 min, with an average of(16.25 ± 1.63) min. Conclusion Endoscopic OTSC clipping system is effective in treating iatrogenic gastric perforation, with fewer postoperative complications and better safety.
引文
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[3]江堤,廖素环,李啸峰,等.单钳道内镜下和谐夹联合尼龙绳行荷包缝合术的临床应用[J].中华胃肠外科杂志,2017,20(7):58-59.
[4]唐静,杨丹,沈文拥,等.单钳道内镜跨越式荷包缝合法在医源性穿孔中的临床研究[J].重庆医学,2018,47(3):387-389.
[5]凌鑫,朱虹,陈天宝,等.单钳道内镜下金属夹联合尼龙绳的荷包缝合术[J].中华消化内镜杂志,2015,32(11):764-766.
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[7]牛琼,刘成霞,王伟,等.OTSC金属夹在封闭急性医源性消化道穿孔中的临床应用[J].中国内镜杂志,2017,23(1):84-86.
[8]孙善明,宋京华,王伟,等.尼龙绳辅助金属夹在内镜治疗性胃穿孔中的应用[J].中国现代医学杂志,2017,29(30):112-116.
[9]关富,陈钟,卢嘉臻,等.OTSC吻合夹在内镜下治疗消化道穿孔和瘘中的应用[J].国际消化病杂志,2016,36(6):347-350.