食管支架置入术后并发症及防治

The Complications After Esophageal Stenting and Their Prevention and Treatment

目的探讨食管支架置入术后的并发症及预防处理措施。方法对140例给予食管支架治疗的患者进行术后临床观察、影像学检查和随访。结果支架置入全部成功,成功率100.0%。术后主要并发症为:胸骨后疼痛及异物感126例(90.0%),胃食管反流23例(16.4%),支架移位15例(10.7%),食管再狭窄13例(9.3%),瘘口封堵不全3例(2.1%),呼吸困难4例(2.9%),支架贴壁不良3例(2.1%),消化道出血28例(20.0%)。随访1～18个月,86例(61.4%)死亡,其中4例(2.9%)死于上消化道大出血,其余病例死于肿瘤消耗或转移。结论食管支架置入术是治疗食管狭窄有效的姑息性方法,积极预防和处理并发症可使该技术更安全有效。

Objective To investigate the prevention and treatment of complications after esophageal stenting.Methods Of all the 140 patients with esophageal stents for treatment,the clinical observation and radiographic check were given.Results All the cases of esophageal stenting were successful and the rate was 100.0%.The main complications were： 126 cases（90.0%） of retrosternal pain and foreign body sensation,23 cases（16.4%） of gastroesophageal reflux,15 cases（10.7%） of stent migration,13 cases（9.3%） of esophageal restenosis,3 cases（2.1%） of incomplete fistula closure,4 cases（2.9%） of dyspnea,3 cases（2.1%） of stent malapposition,28 cases（20.0%） of gastrointestinal bleeding.The follow-up for 1-18 months,86 cases（61.4%） died,including 4 cases（2.9%） died of upper gastrointestinal bleeding and others died of tumor consumption and tumor metastasis.Conclusion Esophageal stenting is the effective palliative treatment for esophageal narrow,preventing and dealing with complications can make the technology safer and more effective.