内镜治疗消化道瘘的临床价值

Clinical Value of Endoscopic Treatment of Digestive Tract Fistula

目的分析、探讨食道、胃、结肠等外科术后瘘及内镜下黏膜剥离术(Endoscopic Submucosal Dissection,ESD)术后瘘的内镜下应对策略。方法回顾性选取2020年1月—2023年3月福建省漳州市第三医院外科收治的60例消化道瘘患者的临床资料,入选患者均接受内镜治疗,根据治疗方式不同分为对照组(钛夹治疗,30例)和观察组(金属架联合尼龙圈治疗,30例),比较两组手术指标、疼痛程度及安全性。结果观察组下床时间、住院时间均明显短于对照组,差异有统计学意义(P均<0.05)。治疗后,观察组疼痛程度评分低于对照组,差异有统计学意义(P<0.05)。观察组并发症总发生率低于对照组,差异有统计学意义(P<0.05)。结论食道、胃、结肠等外科术后瘘及ESD术后瘘的内镜下应对策略中,选取合适的内镜下干预,效果确切,可明显改善患者疼痛程度。

Objective To analyze and discuss the endoscopic coping strategies for postoperative fistula of esophagus,stomach,colon and other surgeries and postoperative fistula of endoscopic submucosal dissection(ESD).Methods Clinical data of 60 patients with digestive tract fistula admitted to the Surgery Department of the Third Hospital of Zhangzhou City in Fujian Province from January 2020 to March 2023 were retrospectively selected.All the enrolled patients received endoscopic treatment and were divided into control group(titanium clip treatment,30 cases)and observation group(treated with frame combined with nylon ringt treatment,30 cases)according to different treatment methods.The surgical indicators,pain degree and safety of the two groups were compared.Results The time of getting out of bed and staying in hospital in the observation group were significantly shorter than those in the control group,the differences were statistically significant(both P<0.05).After treatment,the pain degree score of the observation group was lower than that of the control group,the difference was statistically significant(P<0.05).The total incidence of complications in the observation group was lower than that in the control group,the difference was statistically significant(P<0.05).Conclusion In endoscopic coping strategies for postoperative fistula of esophagus,stomach,colon and other surgeries and ESD postoperative fistula,selecting appropriate endoscopic intervention,the effect is accurate,can significantly improve the pain degree of patients.