金属支架置入治疗食管贲门癌性狭窄

Treatment of malignant esophageal or/and cardiac stricture with placing esophageal metal stents under endoscope

目的探讨内镜直视下置放金属支架对食管贲门癌性狭窄的临床价值。方法32例食管贲门癌性狭窄的患者中食管癌21例,贲门癌3例,食管癌术后吻合口狭窄8例,癌性食管气管瘘4例,均在内镜直视下放置记忆合金支架。支架选择宜以长于病变长度4 cm为宜,即分别长于病变远端及近端2 cm(对贲门癌者远端长出1 cm即可)。结果本组共放置支架32个,一次置入成功率为91%,支架位置偏下调整占9%。全部患者吞咽困难明显改善,总有效率为100%。4例术前食管气管瘘患者,术后均未出现呛咳症状,食管造影证实瘘口消失,患者体重增加,全身状况得到明显提高。结论内镜下置放带膜金属支架是食管贲门癌性狭窄安全、有效的姑息治疗方法,疗效肯定,值得推广。

Objective To investigate the clinical value of malignant esophageal or/and cardiac stricture with placing esophageal metal stents under endoscope. Methods 21 cases of esophageal cancer ,3 cases of cardiac cancer and anastomotic stricture after operation of esophageal cancer in 32 cases of malignant esophageal or/and cardiac stricture were placed with memory alloy stents under endoscope, Result 32 stents were placed . 91% of them were successful at once ,9% stents whose place deviated were adjusted. 4 cases suffering esophageal - trachea fistula were all cured , All patients improve their symptom of taking food difficultly, The effective rate was 100%. Their weigh of body increased and Their health were obvious improved . Conclusion placing esophageal metal stouts under endoscope is a safe and effective palliative treatment to malignant esophageal or/and cardiac stricture and worth popularity.