食道癌放疗后狭窄及食管气管瘘食管内支架治疗方法的探讨

A study analysis on treating postradiation stricture and esophago-tracheal fistula by metallic stent in esophageal carcinoma

目的:评价食管内支架治疗食管癌放疗后狭窄及食管气管瘘的临床效果及方法探讨。方法:本组8例食管癌放疗后狭窄的患者,其中并发食管气管瘘3例,8枚食管内支架置入均在X线电视监视下进行,术后给予抗生素、止血药及镇静止痛药。结果:8例患者均成功置入,其中一例中段食管气管瘘置入支架后一周支架滑脱进入胃腔被取出,另两例中上段食管气管瘘完全被封闭,其进水呛咳症状消失。5例单纯狭窄伴梗阻患者术后吞咽困难完全消除。但其中一例患者食道下段狭窄长于10cm,使用了长14cm宽2.0cm支架术后反应较大,两个月后仍感觉胸骨后疼痛和撑胀感。结论:食管内支架治疗食道癌放疗后狭窄,选用1.8cm以下支架及中上段食道狭窄的患者更为安全有效。

Objective To evaluate metallic stent implantation by their effect at the esophageal carcinoma postradiation stricture （ECPS） and the esophago-tracheal fistula.Methods Metallic stents were implanted in position at 8 patients of ECPS,three of them had the Esophago-tracheal Fistula.All of 8 stents were monitored under the fluoroscopy while having been implanted.And then,they had been given to antibiotic,haemostatic,anodyne after the procedures.Result The stent implantation had been set in the 8 cases successfully.One of them,the stent had slidded into stomach and had been took out successfully,a week late.In two cases,esophago-tracheal fistula in upper-middle esphagus had been sealed completely after the procedures,and the clinical correlation symptom was soon disappeared .The dysphagia were disappeared completely at 5 cases of ECPS.One of the patients whose esophagostenosis was more than 10cm in length and had been used the stent of 2.0cm in diamter and 14cm in length,he still had the chest pain in 2 months.Conclusion Metallic stent,whose diameter is no less 1.8cm should be selected for treatment of ECPS,the treatment of ECPS in upper-middle esophagus is safe and more effective than lower one.