2种金属支架治疗食管、贲门癌术后吻合口良性狭窄的对比研究

A comparion of placement of two metal stents in treatment of anastomotic steruosis after operation on esophagus or preventriculus cancer

目的探讨新型不锈钢CZES型(Z型)支架和镍钛记忆合金网状支架治疗食管、贲门癌术后吻合口良性狭窄的疗效和安全性。方法不锈钢Z型支架置入组13例,置入3个月取出;镍钛记忆合金网状支架置入组13例,置入支架3、4周取出。分析比较2组支架取出后3个月及6个月能正常进食者、吻合口直径及并发症。结果2组支架均成功放置和取出,2组支架均无严重并发症发生。不锈钢Z型支架组取出支架后3个月和6个月仍能正常进食者分别为:92.31%和84.61%;镍钛记忆合金支架组取出支架后3个月和6个月能正常进食者分别为69.23%和46.15%。不锈钢Z型支架组取出后3个月和6个月吻合口平均直径分别为:(13.54±2.60)mm和(12.42±1.93)mm;镍钛记忆合金支架组取出后3个月和6个月吻合口平均直径分别为:(10.69±3.47)mm和(9.78±2.22)mm,2组3个月和6个月吻合口直径比较,差异有显著性(P<0.05)。结论不锈钢Z型支架和镍钛记忆合金网状支架在治疗食管、贲门癌术后吻合口良性狭窄上是有效且安全的,不锈钢Z型支架置入组远期疗效明显优于镍钛记忆合金网状支架组。

[Objective] To evaluate the effectiveness and safety of new stainless steel stents, type Z, and mesh stents in the treatment of anastomotic stenosis after operation on esophagus or preventriculus cancer.[Methods] Stainless steel stent group：Type Z, stainless steel stents were placed in 13 patients with anastomotic stenosis and drawn out after 3 months. Mesh stent group：mesh stents were placed in 13 patients with anastomotic steruosis and drawn out within 3-4 weeks. Compared the patients of two groups, who can eat normally, the anastomotic diameter, and complications that occurred after the stents were drawn out 3 and 6 months respectively. [Results] The stents were both placed and drawn safely in two groups. There were no serious complications happened in both groups.The patients of Stainless steel stent Type Z group, who can eat normally after the stents were drawn out 3 and 6 months, were 92.31% （12/13）, 84.61% （11/13） respectively;And those in mesh stent group who can eat normally after the stents were drawn out 3 and 6 months, were 69.23% （9/13） and 46.15% （6/13） respectively. The mean diameter of the anastomotic stoma was （13.54±2.60） mm and （12.42±1.93） mm respectively after the stents drawn out in stainless steel stent group, while the diameter was （10.69±3.47） mm and （9.78±2.22） mm in mesh group. There were remarkable differences between the two groups of the values in the mean diameter （P 〈0.05）. [Conclusions] Placement of two metal stents is safe and effective in the treatment of anastomotic stenosis after operation on esophagus or preventriculus cancer. The stainless stents is obviously superior to mesh stents in the treatment of anastomotic stenosis in respect of long-term efficacy.