食管金属支架治疗食管狭窄的适应证

Metal Stand Treating Esophageal Stenosis

目的 探讨食管金属支架治疗食管狭窄的适应证。方法 在内窥镜和X线透视下采用食管金属支架治疗食管狭窄。疾病分类 :晚期食管癌、贲门癌 72例 ,食管、贲门癌术后吻合口狭窄 39例 ,食管癌放疗后狭窄 15例 ,食管化学烧伤后狭窄 7例 ,贲门失驰缓症 8例 ,食管癌合并食管气管瘘 3例。置入镍钛记忆合金支架 10 3例次 ,带膜不锈钢支架 47例次。结果 本组食管金属支架操作均 1次性完成 ,支架位置良好 ,吞咽困难程度指数由术前 3 .35降至 1.0 5 (P <0 .0 1) ,患者恢复正常饮食。近期并发症 :下胸痛、支架移位。远期并发症 :返流性食管炎、上消化道出血等。本组无食管穿孔和手术死亡者。结论 食管金属支架治疗食管狭窄 ,操作简单 ,效果确切 ,对晚期食管癌、贲门癌发生的食管恶性狭窄患者 ,能满足其经口进食的要求 ,对提高患者的生存质量有积极意义。而对贲门失驰缓症和食管化学烧伤后所致的食管良性狭窄 。

Objective To investigate the indication of metal stand treatment for esophageal stenosis.Methods 144 cases of esophageal stenosis,which received the metal stand treatment,were analyzed retrospectively.Out of them,72 case were caused from advanced cancer,39 cases from postoperative anastomotic stenosis,15 cases from radiotherapy,7 from chemical burn,8 from cardic spasm syndrome and 3 from malignant esophagus bronchus fistula.103 cases received Nickel Titanium alloyed stand placement,41 cases had membraned stainless stell stand.Results All placements were performed succesefully at the first time.Degree of swallow difficulty reduced from 3.35 to 1.05( P <0.01).The patients were able to take food orally.The complications were as follow:lower chest pain,esophagitis,upper digest tract bleeding.There were no perforation and operation death in our group.Conclusion Metal stand plasement is a simple and useful treatment for esophagus stenosis,it may overcome the difficulty of oral food taking and raise the patients′ life guality.But it should be careful to apply to the esophagus stenosis from cardiac spasm syndrome and chemical burn.