全覆膜可回收支架在常见食管狭窄病变中的临床应用

Clinical Application of Covered Retrievable Stent in Common Esophageal Stricture

【目的】探讨全覆膜可回收支架治疗常见食管狭窄病变的方法及疗效。【方法】采用全覆膜可回收支架（个性化设计）治疗食管狭窄病变107例，其中食管恶性肿瘤59例，食管恶性肿瘤合并瘘2例，食管癌术后恶性狭窄1例，食管癌术后吻合口良性狭窄12例，镍钛记忆合金支架后上端组织增生致狭窄1例，食管癌术后吻合口狭窄并瘘11例，贲门失弛缓症11例，化学性食管狭窄6例，放疗术后致食管狭窄3例，食管间质瘤致食管狭窄1例。吞咽困难症状按Stooler分级术前、术后30d评分。【结果】所有的食管狭窄病变支架置入后均能顺利恢复进食，生活质量明显提高，吞咽困难症状按Stooler分级评分术后总有效率为95．3％。【结论】全覆膜可回收支架治疗常见食管狭窄病变具有疗效好、创伤小、并发症少等优点，值得临床推广运用。

[Objective]To explore the method and efficacy of covered retrievable stent for the treatment of esophageal stricture. [Methods]Totally 107 cases of esophageal stricture were treated by the covered retrievable stent designed individually. Of all patients, 59 patients were esophageal cancer, and 2 patients were esophageal cancer with fistula, and one patient was malignant esophageal stricture after esophagectomy, and 12 patients were benign anastomotic stricture after esophagectomy, and one patient was stricture caused by hy- perblastosis of upper tissue after Ni-Ti memorable metallic stent, and 11 patients were anastomotic stricture with fistula, and 11 patients were achalasia, and 6 patients were chemical esophageal stricture, and 3 patients were esophageal stricture after radiotherapy and one patient was esophageal stricture caused by esophageal stromal tumors. According to Stooler grade, the symptoms of dysphagia were scored before and 30 days after surgery. [Results]All patients after stem implantation were successfully resumed eating, and their quality of life were markedly improved. The total effective rate of improvement of symptoms of dysphagia was 95.3%. [Conclusion] The covered retrievable stent for the treatment of esophageal stricture has the advantages such as good efficacy, little trauma and few postoperative complications. Ifs worthy of clinical promotion.