金属内支架对45例胃十二指肠恶性梗阻的治疗

Treatment of Malignant Gastroduodenal Obstruction with a Metallic Stent

目的:探讨不能手术切除的胃十二指肠恶性梗阻介入治疗的临床价值。方法:45例患者均有明显的梗阻症状,其中胃窦及幽门梗阻17例(37.8%),十二指肠梗阻22例(48.9%),胃十二指肠吻合口梗阻6例(13.3%)。在X线透视监视下,经口腔置入自膨式金属内支架47枚,并对13例患者支架术后1～2周行局部动脉灌注化疗。结果:45例患者中44例一次成功置放支架,一次性技术成功率为97.8%。支架置入后梗阻症状缓解,当日即能进软食,无严重并发症发生。随访时间2～15个月,患者平均生存5.5个月。结论:对于不能或拒绝手术的胃十二指肠恶性梗阻的患者,金属内支架置入是简单、有效、安全、创伤小的治疗方法。

Objective： To explore the clinical value of interventional treatment for inoperable malignant gastroduodenal obstruction. Methods： Data of 45 patients with symptoms of obstruction were reviewed, including 17 with pyloric antrum obstruction, 22 with duodenal obstruction, and 6 with stenotic gastroenterostomy. Under fluoroscopic guidance, 47 metallic self-expanding stents were implanted orally. TAI （transcatheter arterial infusion） was performed for 13 patients after 1 to 2 weeks. Results： Implantation was successfully conducted for 44 patients, with a success rate of 97.8%. Immediate relief of the obstruction was observed and all patients were able to take soft food. No severe complications occurred. The follow-up period was 2 to 15 months, and the mean survival time was 5.5 months. Conclusion： The implantation of metallic self-expanding stents is a simple, effective and safe method for treatment of patients with inoperable malignant gastroduodenal obstruction.