两种内镜下钛夹封闭十二指肠降部穿孔的效果比较及临床应用价值

Comparison and clinical application of two kinds of endoscopic titanium clip for closing duodenal perforation

目的探讨十二指肠降部发生医源性或医源相关性穿孔采用两种内镜下钛夹封闭的效果比较及临床应用价值。方法对于15例十二指肠降部穿孔患者,根据穿孔的具体部位,选择不同的内镜,比较封闭的有效率和成功率。结果 15例十二指肠降部穿孔患者胃镜下封闭8例,封闭成功7例,成功率87.5%;十二指肠镜下封闭7例,封闭成功7例,成功率100.0%。15例患者内镜下钛夹封闭成功14例,失败1例,成功率93.3%。两组患者在有效钛夹数量、无效(损失)钛夹数量及闭合耗时,差异均无统计学意义(P>0.05)。结论对于医源性或医源相关性十二指肠降部穿孔患者采用两种内镜下钛夹封闭都安全、有效,有较好的临床应用价值。

Objective To investigate the effect and clinical application of two kinds of endoscopic titanium clip in treatment of iatrogenic or iatrogenic perforation of duodenal descending part. Methods For 15 cases of perforation of duodenal descending part, according to the specific location of the perforation, select different endoscopic, compare the closing efficiency and success rate. Results 8 cases closed under gastroscopy in 15 cases of descending part of duodenum perforation, successfully closed in 7 cases, success rate was 87.5 %; 7 cases closed under duodenoscopy,successfully closed in 7 cases, the success rate 100.0 %. 14 cases successfully closed by endoscopic titanium clip in15 cases, 1 case failed, the success rate was 93.3 %. The effective titanium clip quantity, invalid（loss） titanium clip quantity and the closing time between the two groups has no statistically significance（P〉0.05）. Conclusion It is safe and effective to use two kinds of endoscopic titanium clips in treatment of iatrogenic or iatrogenic duodenal perforation.