CAJ | 학술논문

目的探讨不同性质的十二指肠嵌顿性异物经胃镜诊断和治疗的可行性,及其临床疗效和安全性.方法纳入2005年1月至2013年12月病历资料完整的37例十二指肠嵌顿性异物患者,回顾性分析经胃镜取出异物的成功率、异物嵌顿的部位、异物的种类和长度,以及并发症等相关情况.结果 37例十二指肠嵌顿性异物患者中,经胃镜安全取出异物35例,转外科手术2例,胃镜治疗成功率为94.6％;异物嵌顿于十二指肠球部8例,十二指肠降部16例,十二指肠水平部8例,十二指肠升部5例;透壁性异物9例.异物种类包括牙签1例,圆珠笔3例,塑料匙2例,挖耳匙1例,牙刷7例,食物团块6例,鸡骨2例,木签(近40枚)1例,带金属钩义齿3例,铁丝3例,玻璃片1例,铁钉5例,刀片2例.胃镜诊治中和诊治后均无大量出血、穿孔等并发症发生.结论十二指肠嵌顿性异物可经胃镜明确诊断和治疗,其可操作性强、创伤小、并发症少、疗效确切,绝大部分能避免外科手术,是诊治十二指肠嵌顿性异物安全、有效的措施.
목적 탐토불동성질적십이지장감돈성이물경위경진단화치료적가행성,급기림상료효화안전성.방법 납입2005년1월지2013년12월병력자료완정적37례십이지장감돈성이물환자,회고성분석경위경취출이물적성공솔、이물감돈적부위、이물적충류화장도,이급병발증등상관정황.결과 37례십이지장감돈성이물환자중,경위경안전취출이물35례,전외과수술2례,위경치료성공솔위94.6％;이물감돈우십이지장구부8례,십이지장강부16례,십이지장수평부8례,십이지장승부5례;투벽성이물9례.이물충류포괄아첨1례,원주필3례,소료시2례,알이시1례,아쇄7례,식물단괴6례,계골2례,목첨(근40매)1례,대금속구의치3례,철사3례,파리편1례,철정5례,도편2례.위경진치중화진치후균무대량출혈、천공등병발증발생.결론 십이지장감돈성이물가경위경명학진단화치료,기가조작성강、창상소、병발증소、료효학절,절대부분능피면외과수술,시진치십이지장감돈성이물안전、유효적조시.
Objective To evaluate the therapeutic approach,feasibility,efficacy and safety of endoscopic diagnosis and therapy in different incarcerated foreign bodies at duodenum.Methods From January 2005 to December 2013,37 patients with incarcerated foreign bodies at duodenum and with complete clinical data were enrolled.The successful rate of foreign bodies removed by gastroscope,the location,type and length of the foreign bodies,and the complications of the 37 patients were retrospectively analyzed.Results Among 37 patients with incarcerated foreign bodies at duodenum,the foreign bodies of 35 cases were successfully removed by gastroscope and the other two were transferred to surgery department for operation,and the successful rate of gastroscopic treatment was 94.6％.Eight cases with incarcerated foreign bodies were at duodenal bulb,16 cases at descendent duodenum,eight cases at horizontal portion of the duodenum and five cases at ascending portion of the duodenum.Nine cases were penetrating foreign bodies.The types of foreign bodies included toothpicks (one case),ball-point pens (three cases),plastics spoons (two cases),earpick (one case),toothbrushes (seven cases),food blocks (six cases),chicken bones (two cases),pegwoods (about 40 pieces,one case),dentures with hook (three cases),iron wires (three cases),glass plate (one case),iron nails (five cases) and razor blades (two cases).There were no complications such as bleeding and perforation during and after endoscopic diagnosis and therapy.Conclusions The incarcerated foreign bodies at duodenum could be diagnosed and treated by endoscope with the andvantage of easy handling,little injury,less complication,exact curative effect and less need for surgery.It is an effective approach to the diagnosis and treatment of incarcerated foreign bodies at duodenum.