超细胃镜下钛镍记忆合金覆膜食管支架置入术36例分析

Implantation of Covered Nitinol Esophageal Stent under Ultrathin Gastroscopy: Analysis of 36 Cases

食管支架置入术可有效改善不能行切除的晚期食管癌患者的吞咽困难症状,提高其生活质量.目的：探讨超细胃镜在钛镍记忆合金覆膜食管支架置入术中的临床价值.方法：对36例晚期食管癌、贲门癌合并吞咽困难患者行超细胃镜下钛镍记忆合金覆膜食管支架置入术,选取27例行普通内镜下食管支架置入术的患者作为对照,严重狭窄者预扩张至7 mm.分析支架置放成功率、定位准确性、支架膨胀扩张效果以及患者依从性和并发症情况.结果：超细胃镜组支架置放成功率100%,定位准确,自膨满意,术后吞咽困难评分显著改善（3.22对0.77）,患者依从性和各种并发症发生率均优于对照组.结论：超细胃镜下钛镍记忆合金覆膜食管支架置入术成功率高,定位准确,操作简便,患者依从性好.

Background： Implantation of esophageal stent can ameliorate dysphagia symptom in patients with unresectable advanced esophageal carcinoma, and improve their quality of life. Aims： To investigate the elinical value of uhrathin gastroseopy in the implantation of covered nitinol esophageal stent. Methods： Thirty-six advanced esophageal and cardiac carcinoma patients complicated with dysphagia received implantation of covered nitinol esophageal stent under ultrathin gastroscopy, and 27 patients receiving conventional implantation of esophageal stent under gastroscopy served as controls. Pre-dilatation to 7 mm was performed in case of severe esophageal stenosis. The success rate of implantation, accuracy of location of stent, self-expanding of stent, patient compliance and complications of inaplantation were analyzed. Results： The success rate of implantation of covered nitinol esophageal stent under uhrathin gastroscopy was 100%, the stent was accurate in location and well self-expanding. The score of dysphagia was significantly ameliorated （3.22 vs. 0.77）, the patient compliance was significantly higher and the complications of implantation were significantly lower than those in controls. Conclusions： Implantation of covered nitinol esophageal stent with ultrathin gastroscope has a high success rate, it is accurate in location, simple in procedure, and it has good patient compliance.