上消化道狭窄及瘘的内支架治疗(附22例报告)

Upper Alimentary Tract Stricture and Esophagotracheal Fistula:Treatment with Metalic Stent

目的评价内支架对上消化道良恶性狭窄及上消化道瘘的治疗价值,总结上消化道内支架的置入操作要点及术后处理经验。材料与方法本组22例,男5例,女7例,年龄45～68岁,平均54岁,食管癌性狭窄11例,食管或胃术后吻合口狭窄8例,食管癌并食管-气管瘘1例,气管插管后气管-食管瘘1例,胃癌术后腹部淋巴结转移幽门狭窄1例。除食管、气管瘘直接安放被膜支架外,单纯狭窄病例均经双腔气囊扩张后经专用输送装置放入裸露式内支架。结果 2例食管瘘支架置入后瘘口封闭,4例食管癌性狭窄置入支架3月内复发狭窄,经内镜下微波烧灼或放疗后梗阻改善,其余均能进普食6个月上,有2例支架滑脱移位。结论食管内支架是解除上消化道狭窄及封闭上消化道瘘的有效而简便的方法,术后处理主要是镇痛及防止支架滑脱,为防止肿瘤生长引起支架阻塞可结合其它治疗。

Purpose To assess the value of metallic stent in the treatment of upper alimentary tract stricture and esophgotracheal fistula and investigate the operative technique and postoperative management.Ma- terial and methods metallic stent was used to treat the upper alimentary tract stricture which had dilated with balloon catheter in 20 patients.Two esophagotracheal fistalas were treated with covered metallic stent.Results All stents were successfully placed without technical failure.The clinical symptoms of esophagotracheal fistula and all strictures were relieved immediately.4 cases with restricture were treated successfully with other methods. Conclusion Metallic stent is an effective and simple method for treatment of upper alimentary tract stricture and fistula.The main postoperative treatments are to reduce local pain,maintain the position of stent and prevent the recurrence of cancer with other methods.