鼻胃镜直视下食管支架置入术40例

Implantation of esophageal stents under transnasal gastroscopy: An analysis of 40 cases

目的:探讨鼻胃镜在食管支架置入中的临床价值.方法:对40例晚期食管癌、贲门癌患者行鼻胃镜直视下食管支架置入术.狭窄严重者应用Savary-gilliard锥形硅胶扩张器预扩张至7mm,经鼻胃镜观察狭窄部位后计算支架推送器插入深度,并在鼻胃镜直视下调节支架推送器以保证支架位置准确,全程无需X线监控.分析支架置放成功率、定位准确性、并发症情况以及吞咽困难改善的效果.结果:40例患者均一次性成功放置食管支架,支架置入成功率100%,定位准确,膨胀满意,术后吞咽困难显著改善(3.52分±0.41分vs1.05分±0.38分,P<0.05),有1例发生迟发穿孔,严重并发症发生率2.5%.结论:鼻胃镜直视下食管支架置入术成功率高,操作简单、安全、定位准确,患者依从性好.

AIM： To assess the clinical value of transnasal gas- troscopy in the implantation of esophageal stents. METHODS： Forty patients with advanced esoph- ageal or cardiac carcinoma developed dysphagia and received implantation of esophageal stents under transnasal gastroscopy. Pre-dilatation to 7 mm was performed in cases of severe esopha- geal stenosis with a cone-shaped Savary-gilliard expander. X-ray monitoring was not used during the whole procedure. The success rate, accuracy, complications of implantation, and improvement of dysphagia were analyzed. RESULTS： The success rate of implantation of esophageal stents was 100%. The stents was accurately placed and well self-expanded. Dys- phagia was improved significantly （dysphagia score： 3.52±0.41 vs 1.05±0.38, P 〈 0.05）. One case developed late-onset perforation, and therate of severe complications was 2.5% CONCLUSION： Implantation of esophageal stents under transnasal gastroscopy is simple, safe, and has a high success rate and good pa- tient compliance.