内镜下置入丹尼斯管进行肠腔内减压治疗肠梗阻的价值。174例患者回顾性临床研究[j]。

S Truong, S Willis, K P Riesener, M Seelig, A Bötjer, V Schumpelick
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引用次数: 3

摘要

回顾性分析174例麻痹性肠梗阻或不同类型部分性小肠梗阻患者的临床资料,探讨内镜下置入丹尼斯管进行腔内减压的疗效。术后早期肠梗阻(A) 66例(37.9%),术后晚期肠梗阻(B) 27例(15.5%),麻痹性肠梗阻(C) 38例(21.8%),晚期腹内肿瘤梗阻(D) 31例(17.8%),克罗恩病炎症性小肠狭窄引起的梗阻(E) 12例(6.8%),97.2%的患者内镜下置管成功。5例无法置管。95例(54.6%)患者成功行长肠管减压术。各组的成功率分别为71.2% (A)、18.5% (B)、86.8% (C)、16.1% (D)、41.7% (E)。75例(43.1%)患者因保守治疗不足而行手术。4例晚期腹腔内肿瘤患者在肠管治疗过程中死亡;术后死亡13例。无管相关死亡,但发生管相关并发症的发生率为6.9%。我们认为,内镜下放置后的腔内肠管减压是麻痹性和术后早期肠梗阻的一种低并发症和高成功率的治疗工具。
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[Value of intraluminal intestinal decompression by endoscopic placement of a Dennis tube in therapy of ileus. Retrospective clinical study of 174 patients].

For determination of the efficacy of intraluminal bowel decompression by an endoscopically placed Dennis tube, 174 patients with paralytic ileus or different kinds of partial small bowel obstruction were reviewed retrospectively. There were 66 cases (37.9%) of early postoperative ileus (A), 27 (15.5%) of late postoperative ileus (B), 38 (21.8%) of paralytic ileus (C), 31 (17.8%) with obstruction due to advanced intraabdominal tumors (D), and 12 (6.8%) of obstructive ileus caused by inflammatory stenosis of the small bowel in Crohn's disease (E). Successful endoscopic placement of the intestinal tube was achieved in 97.2% of patients. Placement of the tube was impossible in 5 cases. A total of 95 patients (54.6%) were successfully managed by long intestinal tube decompression. Success rates for the individual groups were 71.2% (A), 18.5% (B), 86.8% (C), 16.1% (D), and 41.7% (E). Some 75 patients (43.1%) had to be operated on because of insufficient conservative therapy. Four patients with advanced intraabdominal tumors died during the treatment with the intestinal tube; 13 patients died postoperatively. There was no tube-related mortality, but tube-related complications occurred in 6.9%. We conclude that intraluminal intestinal tube decompression after endoscopic placement provides a therapeutic tool with a concomitant low complication and high success rate in paralytic and early postoperative ileus.

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