全覆膜防反流食管支架治疗贲门失弛缓症临床疗效观察

Evaluation of the Results of the Implantation of Membrana Tectoria Anti-reflux Esophageal Stents in Patients With Cardiac Achalasia

目的探讨全覆膜防反流食管支架对贲门失弛缓症的治疗作用。方法34例贲门失弛缓症患者,经胃镜置入全覆膜防反流食管支架,术后2～6周回收支架,观察症状,进行胃镜及胃肠X线检查,了解贲门通畅和胃食管反流情况,并随访观察3～33个月。结果所有患者支架置入均一次成功,其中14.7%(5/34)的患者在治疗期间支架移位,经过2～4次复位,分别在置入2～6周后,顺利取出支架。治疗后所有患者的吞咽困难均明显缓解,由术前的2.91(2～4)分降至0.47(0～1)分;治疗后所有患者贲门畅通,贲门开放直径由术前的0.212(0.1～0.5)cm增至1.432(0.9～1.8)cm;随访期间3例患者(8.82%)分别在第13、15和18个月复发,其余患者食管保持通畅。所有患者均未出现严重不良反应及并发症。结论全覆膜防反流食管支架治疗贲门失弛缓症具有操作简便、疗效好、并发症少、回收方便等优点,但其在体内最佳置入时间和长期疗效有待进一步观察。

Objective:the aim of this study was to evaluate the results of the implantation of membrana tectoria anti-reflux esophageal stents in patients with cardiac achalasia.Methods:The implantations of membrana tectoria anti-reflux esophageal stents were performed under gastroscope in 34 patients with cardiac achalasia and the esophageal stents were retracted after two to six weeks.All the patients were followed for three to thirty-three months,in addition to gastroscopy and radiologic examinations of the esophagu...