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时间:2020-04-30
《CT引导下置管引流治疗胃癌切除术后胃肠道瘘.pdf》由会员上传分享,免费在线阅读,更多相关内容在行业资料-天天文库。
1、放射学实践2014年7月第29卷第7期RadiolPractice,Jul2014,Vol29,No.7841介入放射学CT引导下置管引流治疗胃癌切除术后胃肠道瘘马明平,刘进生,王增林,周东升,杜瑞宾【摘要】目的:评价CT引导下置管引流治疗胃癌切除术后胃肠道瘘的疗效。方法:回顾性分析2009年7月一2013年12月共17例胃癌切除术后吻合1:/瘘及十二指肠残端瘘患者的病例资料,所有病例均行CT引导下经皮穿刺放置引流管交替冲洗引流或持续冲洗引流,并结合持续胃肠减压、抗感染、肠外、肠内营养支持等综合治疗措施进行治疗。结果:所有病例均在CT引导下顺利置
2、入引流管,7例置入单根引流管,1O例置入两根引流管。16例(94)经过引流结合抗感染、营养支持等治疗4~12周后CT复查原积液逐渐吸收、消失,消化道碘水造影显示胃空肠吻合口瘘及食管空肠吻合口瘘闭合,cT扫描显示十二指肠残端瘘残端周围积液腔吸收、消失。16例随访3~6个月胃肠道瘘无复发,1例食管空肠吻合口瘘经穿刺引流及再次手术后仍死于严重感染。结论:CT引导下经皮穿刺放置引流管结合营养支持等综合治疗是胃癌切除术后胃肠道瘘的有效治疗手段,尤其是多根引流管结合生理盐水冲洗引流可能有助于提高引流效果,促进瘘口愈合。【关键词】胃肠道瘘;经皮穿刺引流术;体层
3、摄影术,X线计算机【中图分类号】R816.5【文献标识码】A【文章编号】1000—0313(2014)07—0841—04DO1:1O.13609/j.cnki.1000—0313.2014.O7.027PercutaneouscatheterdrainageunderCTguidanceintreatmentofgastrointestinalleakageaftergastrectomyforgastriccancerMAMing—ping,LIUJin—sheng,WANGZeng—lin,eta1.Departmentofradiolog
4、y,FujianProvincialClinicalCollegeofFu—jianMedicalUniversity,Fuzhou35001,R.RChina[Abstract]0ective:ToevaluatetheeffectivenessofpercutaneouscatheterdrainageunderCTguidanceinthetreat—mentofgastr0intestina1leakageaftergastrectomyforgastriccancer.Methods:FromJuly2009toDecember2013
5、,theclinicaldataof17casesofgastrointestinalleakageincludinganastomoticleakagein13casesandduodenalstumpleakagein4casesaftergastrectomyforgastriccancerwereanalyzedretrospective1y.AllthepatientsweretreatedwithpereutaneouscatheterdrainageunderCTguidancecombinedwithothercomprehens
6、ivetreatmentincludingcontinuousgastrointestinaldecompres—sion,administrationofantibioticandparenteralnutritionandenteralnutrition.Results:PercutaneouscatheterdrainageunderCTguidancewassuccessfullyperformedinallthepatients.Singlecatheterwasplacedin7casesandtwocatheterswereplac
7、edin10cases.Afterpercutaneouscatheterdrainagecombinedwithothercomprehensivetreatment,leakageclosurewasachievedin16(94)patientsandfluidcollectionaroundleakagehadgraduallydisappearedonCTimagesin4to12weeksoffollow-up.Anastomoticleakageclosurewasconfirmedbygastrointestinalfluoros
8、copyusingnonioniccontrastagentandduodenalstumpleakagewasconfirmedwit
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