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中华胃肠内镜电子杂志 ›› 2018, Vol. 05 ›› Issue (02) : 78 -80. doi: 10.3877/cma.j.issn.2095-7157.2018.02.007

所属专题: 文献

论著

医源性结肠穿孔原因分析及处理措施
周燕1, 虎金朋1, 莫丽蓉1, 白飞虎2,()   
  1. 1. 750004 银川,宁夏医科大学
    2. 750021 银川,宁夏人民医院
  • 收稿日期:2018-02-01 出版日期:2018-05-15
  • 通信作者: 白飞虎
  • 基金资助:
    国家自然科学基金(81360323)

Analysis and treatment of iatrogenic colonic perforation in 6 cases

Yan Zhou1, Jinpeng Hu1, Lirong No1, Feihu Bai2,()   

  1. 1. NingXia Medical University, Yinchuan, NingXia Hui Autonomous Region 750021, China
    2. NingXia Hui Autonomous Region People′s Hospital, Yinchuan, NingXia Hui Autonomous Region 750021, China
  • Received:2018-02-01 Published:2018-05-15
  • Corresponding author: Feihu Bai
  • About author:
    Corresponding author: Bai Feihu, Email:
引用本文:

周燕, 虎金朋, 莫丽蓉, 白飞虎. 医源性结肠穿孔原因分析及处理措施[J]. 中华胃肠内镜电子杂志, 2018, 05(02): 78-80.

Yan Zhou, Jinpeng Hu, Lirong No, Feihu Bai. Analysis and treatment of iatrogenic colonic perforation in 6 cases[J]. Chinese Journal of Gastrointestinal Endoscopy(Electronic Edition), 2018, 05(02): 78-80.

目的

探讨结肠镜检查及治疗时发生肠穿孔的原因及对其早期诊断和治疗的方法。

方法

回顾性分析2013年1月至2017年12月经宁夏人民医院总院和分院行结肠镜检查或治疗的25 426例患者的临床资料,记录发生肠穿孔患者的年龄、性别、临床诊断、穿孔部位、穿孔原因及穿孔后的治疗方法。

结果

共有6例发生肠穿孔,其中,5例为即刻穿孔、1例为迟发性穿孔。6例患者中,3例为结肠息肉钳除术患者,内镜下用钛夹封闭穿孔,经保守治疗后出院;另外2例结肠肿瘤溃疡、1例溃疡性结肠炎患者经外科治疗后好转出院。

结论

结肠穿孔是结肠镜诊疗时并不常见的并发症;术前应充分了解患者的临床资料,严格掌握适应证及禁忌证,操作时动作轻柔,可最大程度地减少或避免此类并发症的发生。

Objective

To explore the reasonsand early diagnosis and treatment methods of intestinal perforation which happened in colonoscopy and treatment.

Methods

We retrospectively analyzed the clinical data of 25 426 patients undergoing colonoscopy in 5 years of NingXia People′s hospital headquarters and branch offices and recorded the age,gender,clinical diagnosis,perforation site,perforation causes and treatments after intestinal perforation.

Results

There were 6 cases of intestinal perforation, of which 5 had immediate perforation and 1 had delayed perforation. Of the 6 patients, 3 underwent colon polypus forceps. Endoscopic perforation was performed with titanium clips, and all the three patients were discharged after conservative treatment. In addition, 2 patients with colon tumor ulcers and 1 patients with ulcerative colitis were discharged after surgical treatment for performation.

Conclusion

Colonic perforation is an uncommon complication during colonoscopy. Fully understanding the clinical data, fully estimation the indications and contraindications before operation of patients and gental operation could greatly reduced even avoided the incidence of such complications.

[1]
Iqbal CW,Cullinane DC,Schiller HJ,et al.Surgical management and outcomes of 165 colonoscopic perforations from a single institution[J].Arch Surg,2008,143(7):701-706.
[2]
李曙光,李洪涛,胡世荣,等.纤维结肠镜检查并发肠穿孔2例报告[J].张家口医学院学报,2001,18(4):89-90.
[3]
Arora G,Mannslithara A,Singh G,et al.Risk of perforation from a colonoscopy in adults:a large population-based study[J].Gastrointest Endosc,2009,69(3 Pt 2):654-664.
[4]
张钦增,侯化丽,唐文东,等.纤维结肠镜检查治疗致肠穿孔原因分析及预防措施[J].临床误诊误治,2007,20(10):75-76.
[5]
Bai XS,Liu XQ,Pang JQ,et al.Analysis about diagnosis and therapy of colonoscopic perforations of 37 patients[J].Chin J Gen Practitioners,2005,4(9):544.
[6]
王秋生,张阳德.内镜腹腔镜外科学[M].北京:中国医药科技出版社,2001:327-340.
[7]
丁春生,王玉东.造成结肠镜检查失败的原因分析[J].实用医技杂志,2007,14(8):999.
[8]
Wullstein C,Koppen M,Gross E.Laparoscopic treatment of colonic perforations related to colonoscopy[J].Surg Endosc,1999,13(5):484-487.
[9]
Carpio G,AlbuE,Gumbs MA,et al.Management of colonic perforation after colonoscopy.Report of three cases[J].Dis Colon Rectum,1989,32(7):624-626.
[10]
Anderson ML,Pasha TM,Leighton JA.Endoscopic perforation of the colon:lessons from a 10-year study[J].Am J Gastroenterol,2000,95(12):3418-3422.
[11]
王玫,陈建平,庄耘,孙克文,等,内镜下钛夹处理医源性消化道急性穿孔15例分析[J].临床消化病杂志2012,24(6):357.
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