内镜直视下食管支架置入术并发症78例临床分析

Clinical analysis of complications in 78 cases of endoscopic esophageal stenting

目的探讨内镜直视下食管支架置入术后并发症的原因及治疗方法。方法对经内镜直视下食管支架置入治疗食管癌(食管狭窄)78例患者进行临床观察、影像学检查和电话随访,分析总结主要并发症。结果主要并发症为:胸骨后疼痛37例(47.4%),消化道出血24例(30.8%),胃食管反流14例(17.9%),支架移位11例(14.1%),再狭窄9例(11.5%),呃逆8例(10.3%),食管气管瘘4例(5.1%),食物嵌顿3例(3.8%)等。结论内镜直视下食管支架置入术能有效改善食管贲门癌梗阻症状,是治疗晚期食管癌有效的姑息治疗方法,但其并发症的种类繁多,严重并发症危及生命,积极预防和采取有效的处理方法可延长食管癌(食管狭窄)患者的生存时间。

Objective To discuss the reason and treatment of complications of endoscopic stent implantation. Methods The clinical observation,imaging and communications follow-up have been performed for 78 patients with esophageal cancer esophageal stent placement （esophageal stricture）,then the major complications have been analyzed and summarized.Results The main complications were as follows：chest pain in 37 cases （47.4%）,gastrointestinal bleeding in 24 patients（30.8%）,gastro-esophageal reflux in 14 cases（17.9%）,stent migration in 11 cases（14.1%）,restenosis 9 cases（11.5%）,hiccup in 8 cases（10.3%）,esophageal fistula,4 cases（5.1%）,food impaction in 3 cases （3.8%）.Conclusion Endoscopic esophageal stent implantation can effectively improve the symptoms of esophageal cardiac obstruction,this method is an effective palliative treatment for late esophageal cancer,but it will bring more complications,the severe one will threaten the patient＇s life. The survival time of patient of esophageal cancer（esophageal stricture）may be extended by the effective approach.