暂时性内支架治疗食管良性狭窄疗效分析

Esophageal benign stricture with temporary stent insertion

目的分析暂时性内支架治疗食管良性狭窄疗效，为食管良性狭窄提供有效的介入治疗方法。对象与方法１２例食管良性狭窄患者食管最窄处直径１ｍｍ～５ｍｍ，吞咽困难评分为３～４级。在Ｘ线下置入可扩张金属带膜内支架，术后３～７天由胃镜取出内支架。结果１２例患者支架置入和支架取出成功率均为１００％。操作死亡率为０％。支架置入后吞咽困难明显好转，吞咽困难评分０级－１级，平均０．６±０．４级；支架取出后吞咽困难评分０级～２级，平均０．８±０．５级。支架置入后管腔直径１６～２２ｍｍ，平均１８．４±２．９ｍｍ。支架取出后一周内管腔直径１０ｍｍ～１８ｍｍ，平均１４．５±２．７ｍｍ。患者术后随访３～５０个月。随访期内管腔直径未见明显改变，吞咽能力在随访３个月内逐渐好转，３个月后处于维持状态。

Objective To study and provide an effective method for treating esophageal benign strictures with temporary stent insertion. Materials and Methods 12 patients with temporary stent insertion for treating esophageal benign strictures suffuring from different degrees of dysphagia. All stents were insterted under radiologic controll and drawn out of the 3～7 days via gastroscopy. The degress of dysphagia were considered as 3～4 grades with mean 3.0±0.84. Results Temporary stent insertion was technically successful and dysphagia was effectively remitted in all 12 patients. The dysphagia scores were 3.0±0.8 before stent insertion, 0.6 ±0.4 after stent insertion and 0.8±0.5 after stent removal. The mean diameter of esophageal lumen was 3.6±1.3mm before stent insertion, 18.4±2.9mm after stent insertionand 14.5±2.7mm after stent removal. Follow up time was from 3 months to 50 months(mean 12.3±2.57 months). The complications were chest pain(n=7) and reflux(n=5) after stent insertion and bleeding(n=2) and reflux(n=3) after stent removal.Conclusion Esophageal benign stricture with temporary stent insertion was one of the most effective method.