金属内支架在治疗食管狭窄及食管瘘中的临床应用

The Clinical use nf Metallic Internal stent in the Treatment of Patients with Esopheal Stricture and Fistula

目的 探计应用金属内支架在治疗食管良、恶性狭窄及食管瘘在临床上的应用价值。方法 共26例患者，其中不能手术的晚期食管癌6例，食管癌放疗后引起的食管狭窄10例，手术后吻合口狭窄5例，腐蚀性食管炎2例，责门失驰症3例。合并食管-气管瘘或食管-纵隔瘘3例。全部在透视下进行，口咽局部表面麻醉。结果 全部病例均获成功，其中1例患者，支架植入后1个月有下移现象，3例术后半年发生再狭窄。结论（1）良性食管狭窄病人应慎做金属内支架植入术；（2）责门失弛缓症不宜植入永久性金属内支架；（3）不能手术的食管癌及放疗后食管狭窄，食管．气管瘘和食管-纵隔瘘的病人，金属内支架应作为首选治疗方法。

Objective To evaluate the clinical application of metallic stents in the treatment of benign and malignant esophageal strictures and esophageal-tracheal fistula or esophagomediastinum fistula. Methods 26 cases had intraluminal metallic stents intubation. The strictures were caused by advanced esophageal carcinoma（n=6）, post-radiotherapy stricture（n=10）, post-operative anastomotic stricture（n=5）, ingestion of alkali（n=2）and achalasia（n=3） as well as 3 cases with esophageal-tracheal fistula or esophagomediastinum fistula. The intervention was pertbrmed under fluoroscopic guidance and local oropharyngeal anaesthesia. Results All cases had their stent placed successfully, from which one case moved down after one month, 3 cases had restricture after half a year. Conclusion 1.Patients with benign esophageal stricture should cautiously implant metallic stent. 2.Permanent metallic stent did not tbod for patients with achalasia. 3.Metallic internal stent was first method of choice for patients with advanced esophageal carcinoma and post-radiotherapy stricture, esophageal-tracheal fistula or esophagomediastinum fistula.