食管支架置入术的临床应用

Clinical application of esophageal stent implantation

目的探讨食管支架置入术对良、恶性食管狭窄和食管瘘的治疗方法、疗效和并发症的处理。方法对55例不同原因所致良、恶性食管狭窄和食管瘘患者采用食管金属支架置入术。结果食管狭窄的主要症状吞咽困难、呛咳得到改善，近期疗效达100％。出现的并发症主要为疼痛和大便隐血，发生率分别为100％和92．7％，其余依次为胃食管返流、食管再狭窄、支架脱落，经过治疗后得到缓解或消失。结论金属支架置入术是治疗中晚期食管癌、狭窄的有效方法之一，对食管良性狭窄和瘘效果亦好。并发症可以预防，处理后大部分缓解。

Objective To study therapy and efficacy of esophageal stent implantation for benign and malignant esophageal stricture and esophageal fistula and discuss management of complications. Methods A total of 55 cases with benign and malignant esophageal stricture and esophageal fistula caused by different factors were treated with esophageal stent implantation. Results The dysphagia and bucking caused by esophageal strictures were improved, with excellent short-term curative effect for 100%. Major complications included pain and stool occult blood, with incidence rates of 100% and 92. 7% respectively. Other complications were gastroesophageal reflux, esophageal restenosis and stent migration by turns, which could be relieved or even disappeared with treatment. Conclusions Esophageal stent implantation is one of effective methods not only for treating esophageal carcinoma and malignant esophageal strictures but also for treating benign esophageal strictures and fistula. The complications can be prevented and most of them can be relieved by treatment.