阳性结肠穿孔:内镜治疗或手术
1Department of Gastroenterology, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea.
Clinical endoscopy
|October 28, 2025
概括
结肠镜检查引起的阳性结肠穿孔需要及时识别. 管理包括对轻微缺陷进行内镜关闭或对严重病例进行手术,遵循国际指导方针.
科学领域:
- 胃肠病学 胃肠病学
- 内視鏡外科手術 內視鏡外科手術
背景情况:
- 阴性结肠穿孔是结肠镜检查的一个罕见但严重的并发症.
- 治疗性结肠镜手术具有更高的风险.
- 及时诊断和管理对于患者的治疗结果至关重要.
研究的目的:
- 审查目前对阳性结肠穿孔的治疗策略.
- 总结基于国际准则的管理建议.
- 突出预防措施和风险因素.
主要方法:
- 关于结肠镜术并发症的主要国际指南的文献综述.
- 对iatrogenic结肠穿孔的治疗策略的分析.
- 对内镜和手术干预的数据的综合.
主要成果:
- 内镜闭合 (剪切,内环, suturing) 是有效的选择轻微的,早期检测到穿孔与良好的肠道准备.
- 对于较大,延迟或复杂的穿孔,有污染或恶化,需要进行外科手术.
- 危险因素包括老年,分,以及肠道准备不足.
结论:
- 基于穿孔特性的个性化管理是必不可少的.
- 在特定情况下,内镜闭合提供了一个可行的选择.
- 专注于风险因素识别和最佳肠道准备的预防策略至关重要.
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