记忆合金支架在胃出口和十二指肠恶性梗阻中的应用

Clinical studies of self-expandable nitinol stent on relieving malig nant obstruction of gastric outlet or duodenum

目的 探讨胃出口、十二指肠恶性梗阻时镍钛记忆合金支架置入的操作技术及其临床疗效。方法 16例中胃窦癌 2例 ,胃窦癌术后复发伴吻合口狭窄 2例 ,贲门癌术后复发伴幽门梗阻 4例 ,结肠癌晚期伴胆管、十二指肠恶性梗阻 1例 ,胰头癌浸润十二指肠 3例 ,十二指肠癌 4例。所有患者均在X线监视下行气囊扩张后进行支架置入。结果 支架一次置入成功 15例 ,成功率 93 8%。其中有 2例为双支架置入 (同时置胆总管支架 )。支架置入后 1周 ,患者腹胀消失率为 11/ 15 (73 3% ) ,呕吐消失率为 13/ 15 (86 7% )。未发生与操作相关的近期并发症。结论 采用镍钛记忆合金支架治疗胃出口、十二指肠恶性狭窄 ,能明显改善患者生存质量 。

Objective To study the technique of placemen t of Nitinol stent for relieving malignant pylorus or duodenal obstruction, and to assess its clinical effectiveness.Methods In this group the strictures were caused by gastric car cinoma at the antrum (n=2), anastomosis site of previous gastrojejunostomy (n=2 ), gastric carcinoma at the cardia (n=4), colon cancer (n=1), pancreatic cancer (n=3) and duodenal cancer (n=4). Under fluoroscopic guidance the Nitinol stent w as inserted into pylorus or duodenal obstruction sites via oral cavity in all ca ses. Complications and clinical status were investigated during the study period .Results Successful stent placement was achieved in 15 cases. Tw o patients had undergone double stent placement (pylorus stent and bile duct ste nt). The rate of improvement in abdominal distention and vomiting 1 week after p rocedure was 73 3% and 86 7% respectively. Procedure-related complications ne ver occurred.Conclusion Nitinol alloy network stent is a safe and efficaciou s method for palliating malignant pylorus or duodenal obstruction, and improves patient's living quality.