摘要
目的:观察和评价内镜下放置食管镍钛记忆金属带膜支架,姑息治疗晚期食管癌吞咽困难和食管气管瘘 /纵隔瘘的疗效、并发症及对生存期的影响。方法:治疗组胃镜下(部分进导丝时合用 X线监视)放置国产和进口镍钛记忆金属带膜支架 21例。共放置支架 25枚,其中国产 21枚,进口 4枚。对照组为我院收治的 27例晚期食管癌吞咽困难患者,行胃造瘘和静脉营养姑息治疗。结果:治疗组 24枚支架安置定位准确,扩张满意, 1枚位置偏高 1.0 cm。食管最狭窄处内径由 (1.86± 2.69) mm扩至 (13.91± 1.81) mm,食管气管瘘/纵隔瘘被覆盖阻断。吞咽困难评级( 0~ 4级)由平均 3.48± 0.75降至 0.90± 0.54。术后一周生活质量评分( Karnofsky)平均提高 30.09± 5.08。治疗组和对照组的半年生存率为 71.43%与 11.11%, 1年生存率为 14.29%与 0,中位生存期为 7个月与 3个月, Log- rank检验,两组差异有统计学意义( P<0.0001)结论:该方法简便、准确、安全,明显改善吞咽困难,提高生活质量,延长生存期。
Objective: The current study was designed to evaluate the outcomes and complications of palliative treatment which alleviate dysphagia and symptoms of esophagotracheal or esophagomediastinal fistulas for late- stage esophageal carcinoma by placement of covered Ni- Ti Alloy stents under endoscopy and discuss the effects of this treatmeut on survival. Methods: Twenty- one cases of late- stage esophageal carcinoma which were treated by placement of covered Ni- Ti Alloy stents under endoscopy were included in this group. Twenty- five stents were placed among these patients, including 21 stents made in China and 4 imported. Control group was 27 cases of late- stage esophageal carcinoma who suffered from dysphagia and were treated by gastrostomy and intravenous nutrition. Results: Twenty- four stents were placed correctly with satisfying dilatation in treatment group, while 1 stent was placed 1.0 centimeter above its expected position. The shortest diameter of esophagostenosis was expanded from (1.86± 2.69) mm to(13.91± 1.81)mm and esophagotracheal or esophagomediastinal fistulas were also occluded by the stents. The grades of dysphagia(grade 0- 4) were lowered from(3.48± 0.75) to (0.90± 0.54). Karnofsky performance score was increased 30.09± 5.08 one week following operation. The half- year survival rates of treatment group and control group were 71.45% and 11.11% , respectively; one year survival rates of these two groups were 14.21% and 0, respectively,and the mean survival durations were 7 months and 3 months, respectively; Log- rank test showed there was statistical significance between these two groups. Conclusions: This treatment is simple and safe for patients with late- stage esophageal carcinoma and can greatly alleviate dysphagia, improve life quality and prolong survival time.
出处
《癌症》
SCIE
CAS
CSCD
北大核心
2000年第11期1027-1029,共3页
Chinese Journal of Cancer
关键词
食管肿瘤
内窥镜
镍钛记忆金属支架
Esophageal neoplasms/therapy
Esophage alstenosis/complication
Stent/therapeutic usage