全覆膜可回收支架联合经鼻胃空肠管治疗食管穿孔病变

Observation on the Efficacy of Retrievable Covered Stent and Nasogastrojejunal Tube in the Treatment of Esophageal Perforation

[目的] 探讨全覆膜可回收支架联合经鼻胃空肠管治疗食管穿孔病变的方法及疗效.[方法] 47例食管穿孔患者随机分为两组,对照组23例采用全覆膜可回收支架治疗,治疗组24例采用全覆膜可回收支架联合经鼻胃空肠管治疗,观察两组的临床疗效、堵瘘成功率、堵瘘所需时间、并发症、病死率、住院时间、住院费用等.[结果] 治疗组堵漏成功率95.8%（23/24）,对照组91.3%（21/23）,两相比较差异无显著性（P〉0.05）;堵瘘所需时间对照组为（12.2±5.9） d,治疗组为（8.3±3.2） d,两组差异有统计学意义（P〈0.05）;住院时间治疗组（14.3±4.2） d较对照组（22.2±5.5） d显著缩短（P〈0.05）;住院费用治疗组（2.3±1.2）万元较对照组（4.2±1.7）万元显著减少（P〈0.05）.治疗组术后出现并发症3例,死亡2例;对照组并发症3例,死亡3例,差异无统计学意义（P〉0.05）.[结论]全覆膜可回收支架联合经鼻胃空肠管治疗食管穿孔病变安全有效、创伤小、费用低,值得临床推广运用.

[Objective] To explore the efficacy of full covered retrievable stent and nasogastrojejunal tube in the treatment of esophageal perforation. [Methods] Forty seven patients with esophageal perforation were random- ly divided into two groups. The control group（n=23） was treated with full covered retrievable stent. The treatment group was treated with full covered retrievable stent and nasogastrojejunal tube. The clinical efficacy, the successful rate and duration of fistula closure, complications, mortality, hospital stay and hospitalization cost of two groups were observed. [Results] The successful rate of fistula closure in treatment group and control group were 95.8% （23/24） and 91.3 % （21/23） respectively, but there was no significant difference between two groups （ P 〉0.05）. The duration of fistula closure in control group and treatment group were （12.2±5.9）d and （8.3± 3.2）d, and there was significant difference between two groups（ P 〈0.05）. The hospital stay in treatment group [（14.3±4.2）d] was shorter than that in control group[（22.2±5.5）d, P 〈0.05]. The hospitalization cost in treatment group[（2, 3000±12,000） yuan] was lower than that in control group [（42,000±17,000） yuan]（ P 0.05）. In treatment group, 3 cases had the postoperative complications and 2 cases died. In control group, 3 cases had the postoperative complications and 2 cases died. There was no significant difference in the incidence of eompli cations and mortality between two groups（ P 〉0.05）. [Conclusion] Full covered retrievable stent combined with nasogastrojejunal tube is safe and effective with less invasive and low cost, so it is worthy of clinical promotion.