内镜下放置金属支架治疗幽门及十二指肠恶性狭窄的临床疗效分析

The Analysis of Clinical Curative Effect of Putting Metal Stent to Treat the Malignant Obstruction of Pylorus Using Endoscope

目的评价内镜下放置金属支架在治疗幽门及十二指肠恶性狭窄的临床疗效。资料与方法选择晚期胃窦癌16例、幽门管癌8例和十二指肠癌5例作为支架组,在内镜下放置金属支架。选择同期18例晚期胃窦癌、幽门管癌7例和3例十二指肠癌为手术组,行姑息性胃-空肠吻合手术。观察支架组支架置入成功率和幽门或十二指肠狭窄改善情况及两组患者生活质量状况、生存时间、副作用、平均住院时间和平均住院费用。结果支架组支架放置成功率为96.6%,幽门和十二指肠狭窄有明显改善,生活质量明显改善,生存时间延长,与手术组相比无统计学差异。但支架组平均住院时间为5天,平均住院费用为0.65万元,手术组平均住院时间为11天,平均住院费用约为1.51万元,副作用也明显少于手术组。结论内镜下放置金属支架不但能解决幽门和十二指肠恶性狭窄,提高患者的生活质量,延长患者生存时间,还能减少平均住院时间和医疗费用,是缓解幽门及十二指肠恶性狭窄的理想方法之一。

Objective To evaluate the clinical curative effect of putting metal stent to treat the malignant obstruction of pylorus. Materials and Methods 16 cases advanced sinus ventriculi carcinoma,8 cases advanced canalis pyloricus carcinoma and 5 cases advanced dodecadactylon carcinoma were selected as stent group to put metal stent using endoscope. 18 cases advanced sinus ventriculi carcinoma,7 cases advanced canalis pyloricus carcinoma and 3 cases advanced dodecadactylon carcinoma were selected as operation group to carry out palliative stomach-jejunal anastomosis. The achievement rate of putting the stent and the improvement condition of obstruction of pylorus or dodecadactylon in stent group were observed. And the life quality,live time,side effect,average time and health care cost of hospitalization of the two groups were compared. Results The achievement rates of putting the stent were 96.6% in stent group. The pylorus obstruction and the life quality had evident improvement. The live time of patients were prolonged but there was not a significant difference on the results of two groups,P〉 0.05. However,the average time of hospitalization in stent group and operation group was 5 days and 11day,respectively. The average health care of hospitalization in stent group and operation group and health care cost of was 0.65 ten thousands and 1.51 ten thousands,and the side effects of stent group were little than operation group. Conclusion Putting metal stent is a better way for pylorus and dodecadactylon malignant obstruction using endoscope.