非X光胃镜直视下放置支架治疗食管狭窄及食管瘘的临床研究

A clinical study of placing a trestle to treat a narrow esophagus fistula under a non-X ray gastroscope

目的 :使用金属支架治疗食管狭窄及食管瘘。方法 :在非X光胃镜直视下放置镍钛记忆合金支架治疗食管狭窄 32例 ,其中食管癌所致食管狭窄 2 5例 (5例合并食管支气管瘘 ) ,食管癌术后吻合口狭窄 7例 ,其中 2例复发 ,术后给予放疗。结果 :本组病例术前均有明显吞咽困难 ,一次放置成功率 10 0 % ,术中无食管出血及食管破裂等并发症发生 ,术后吞咽困难明显好转 ,食管瘘愈合 5例 ,术后与术前比较 ,吞咽困难明显改善达两个级别以上 ,经统计学处理有显著性差异 ,P <0 .0 1。胸痛和返流性食管炎是最常见的术后并发症。结论 :非X光胃镜直视下放置支架治疗食管狭窄及食管瘘安全可靠 ,疗效确切 ,创伤小 ,对于提高病人生活质量 ,延长病人生存时间是一种行之有效的治疗方法 ,术后放疗效果更佳。

Objective: The metal trestle is applied to treat narrow esophagus or esophagus fistula. Method: We have placed the nickel titanium memorial alloy trestle to treat 32 examples of narrow esophagus,25 of which were caused of esophagus cancer-5 examples merged esophagus bronchus fistula.After operation of esophagus cancer,identical wound is narrow in 7 examples.2 of which had a relapse again and were given a radioactive treatment after operation. Result: This group of patients have obvious trouble in swallowing before operation.We succeeded in placing the trestle at one time up to 100%.During the operation,the esophagus didn’t bleed or burst or occur complication.The swallow trouble changed better obviously after the operation.Five people suffering from esophagus fistula have healed.Compared pre-operation with post-operation,the swallow trouble has been improved obviously over two ranks.Through the statistics,there was notable difference.P<0.01,Chestache and returning esophagitis are the most common complications after operation. Conclusion: To place a trestle to treat a narrow esophagus or esophagus fistula under a non-X ray gastroscope is safe and reliable,with exactly curative effect and small wound.That is a better way to improve the patient's living quality and lengthen the patient’s living time.To carry out a radioactive treatment after operation will have a better effect.