食管内照射支架治疗晚期食管癌六年回顾性分析

Self-expandable medical memorial metallic stent with ^(125)Ⅰ seeds for the treatment of esophageal carcinoma:a retrospective analysis

目的观察食管置入内照射支架的疗效及安全性。方法回顾分析32例晚期食管癌患者置入食管内照射支架后支架置入的时间和置入成功率、即时疗效、近中期疗效、生存期、并发症、体重、血象、免疫指标、平均住院时间和住院费用。结果支架置入术操作时间平均(18±5)min,置入成功率100%,释放过程中无放射粒子脱落,吞咽困难缓解率为100%,4例患者出现再狭窄,1例出现支架移位,术后1个月卡氏评分达60分以上的患者增至90%,术后生存时间平均(8.7±6.6)个月,平均住院日为(7.8±3.7)d,平均住院费为(1.2±0.3)万元。结论 125I种子源食管内照射支架临床应用安全有效,操作便捷,能有效延长患者生存期。

Objective To discuss the curative effect and safety of the implantation of self-expandable medical memorial metallic stent with ^（125）Ⅰ seeds for the treatment of advanced esophageal carcinomas.Methods Implantation of self-expandable medical memorial metallic stent with ^（125）Ⅰseeds was performed in 32 patients with advanced esophageal cancer.The clinical data were retrospectively analyzed.The technical success rate,the operation time,the immediate and mid-term effectiveness,the survival time,the complications,the body weight,the blood picture,the immune indexes,the average hospitalization days and hospitalization expenses were analyzed.Results The average operation time was（18 ± 5） minutes.Successful stent implantation was achieved in all 32 patients（100%）.No 125I seeds fell off during the procedure.The remission rate of dysphagia was 100%.Esophageal restenosis occurred in four patients,and displacement of the stent was seen in one patient.One month after the treatment,90% of patients had a Karnofsky performance score over 60.The mean survival time was（8.7 ± 6.6） months.The average hospitalization time was（7.8 ± 3.7） days and the mean hospitalization cost was（12 ± 3） thousand Chinese yuan.Conclusion For the treatment of esophageal carcinomas,the implantation of self-expandable medical memorial metallic stent with ^（125）Ⅰ seeds is safe,effective and simple.This treatment can markedly improve the symptom of dysphagia and significantly prolong the patient＇s survival time.