食管支架不同方法置入术58例临床体会

Comparison of different intervention procedures of esophageal stent under endoscopy:an analysis of 58 cases

目的观察与评价内镜下不同方法食管支架置入术治疗中晚期食管癌及吻合口狭窄的临床疗效。方法对41例中晚期食管贲门癌性狭窄和17例食管吻合口狭窄采用扩张,X线下操作,内镜下不同方法的操作,放置不带膜或者带膜支架,并比较其在良恶性狭窄中的优缺点。结果58例患者均成功放置食管支架,显著改善了患者的营养状态,无严重并发症的发生。结论食管支架置入术是治疗食管良恶性狭窄较好的方法之一,几种方法都能较准确的放置食管支架,内镜直视下推放支架简单,准确性好。对吻合口狭窄放置可回收支架代替多次扩张,疗效好,痛苦小。

Objective To observe and evaluate clinical efficacy of different intervention procedures of endoscopic stenting in treatment of medium and late stages of esophageal carcinoma and anastomotic stenosis. Methods 41 cases of medium and late stages of oesophageal and cardial carcinomas and 17 cases of anastomotic stenosis in upper gastrointestinal tract were trea- ted by dilation under endoscopies. Coated or bare esophageal stent were inserted under endoscopic vision with or without x-ray guidance with all the cases. Results It suggests that endoscopic metal stentlng implantation is a feasible and practical man- agement in treating esophageal stenosis. Conclusion The method of endoscopic vision is a safe and reliable approach. Self-re- trieve metal stent is effective and less painful for anastomotic stoma stricture,which is superior to multiple dilation.