经皮内镜下胃造瘘空肠置管术在高位肠外瘘患者中的临床应用

目的探讨经皮内镜下胃造瘘空肠置管术治疗高位肠外瘘患者的方法、并发症及疗效。方法回顾性分析经皮内镜下胃造瘘空肠置管术治疗我院24例高位肠外瘘患者的手术操作时间、成功率、并发症、导管留置时间及肠瘘治愈率。结果所有患者均置管成功,成功率为100%,平均置管时间为(16.5±3.8)min,无置管相关并发症;置管后并发症发生率为12.5%(3/24):2例营养管堵塞,1例造瘘管周围感染,平均导管留置时间(83.7±46.2)d。18例患者肠瘘愈合,治愈率为75%(18/24),5例肠瘘未愈行外科手术治疗,1例因原发病死亡。结论经皮内镜下胃造瘘空肠置管术具有操作简单易行、安全,住院时间短,空肠营养管越过肠瘘给予肠内营养等优点,可用于高位肠外瘘患者的临床治疗。

Clinical application of percutaneous endoscopic gastrojejunostomy in high gastrointestinal fistula patients

Objective To investigate the therapies,complications and clinical efficacy of percutaneous endoscopic gastrojejunostomy in high gastrointestinal fistula. Methods Twenty-four high gastrointestinal fistula patients who received percutaneous endoscopic gastrojejunostomy were analyzed retrospectively in our hospital.The analyzed data included the operation time,success rate,complications,duration of catheter placement cure rate. Results All tubes were successfully placed(100%) in an average time of(16.5±3.8) min.None of stud patients developed operation-related complications.The percentage of complications after the procedure was 12.5%(3/24),Tubes blocked in 2 cases and wound infection was found 1 case.The average duration time of tube functioning was(83.7±46.2) d.The gastrointestinal fistula was cure in 18 cases (75%,18/24).Five cases who were uncurable received surgery and one case died of original disease. Conclusion Percutaneous endoscopic gastrojejunostomy is a convenient and safe method,easily accepted by patients.The therapy can shorten time of hospitalization and give enteral nutrition over gastrointestinal fistula by providing jejuna tube feeding.It also has a satisfactory treatment effect in high gastrointestinal fistula.