覆膜食管支架置入术60例临床应用分析

Effect of esophageal stent surgery clinical analysis with 60 cases report

目的：分析晚期食管癌狭窄、纵隔淋巴结增大侵犯食管狭窄、贲门失弛缓症和食管术后吻合口狭窄、腐蚀性食管狭窄及食管破裂、食管-纵隔瘘、食管-气管瘘等病变的食管支架置入术的治疗方法及效果。方法60例中，晚期食管癌患者22例；食管癌并食管-气管瘘1例；纵隔内淋巴结增大侵犯食管导致食管狭窄10例；贲门失弛缓症18例；食管癌术后狭窄5例及腐蚀局限性食管狭窄2例；食管胸腔瘘1例、食管-纵隔瘘1例；60例均采用数字多功能X线机透视引导，其中部分病例同时采用胃镜下置入导丝放置支架治疗。结果60例患者中恶性狭窄永久性植入支架33例；良性狭窄暂时性置入支架27例，暂时性置入支架均在3-28 d安全取出；支架留置以后98％（59/60）患者的摄食能力有了很大提高，生活质量明显改善。结论食管支架置入术，简捷、安全、有效，对提高食管狭窄及食管瘘患者的生活质量、延长生命是一个好的治疗方法。

Objective To study advanced esophageal stricture, loss of mediastinal lymph nodes enlarged in-fringement of esophageal stenosis, cardiac disorders and postoperative anastomotic stenosis of the esophagus, corrosive esophageal stenosis and esophageal rupture, esophageal mediastinal fistula, esophageal-tracheal fistula pathological changes such as the method and result of the treatment of esophageal carotid stenting. Methods Of 60 cases, 22 pa-tients with advanced esophageal cancer; esophageal cancer and esophageal-tracheal fistula in 1 case; mediastinal lymph nodes enlarged offender in the esophagus in 10 cases of esophageal stenosis;18 cases of cardiac relaxation loss disease; Five cases of postoperative esophageal stenosis, esophageal stricture in 2 cases and corrosion limitations, esophageal thoracic cavity fistula in 1 case, esophageal mediastinal fistula in 1 case;60 patients adopted digital multi-function X-ray machine perspective guidance, some of the cases at the same time adopted in godet stenting treatment. Results Of 60 cases, malignant stenosis in patients with permanent stents were implanted in 33 cases; benign stric-ture temporary placement stents in 27 cases and temporary placement were removed in 3-28 d security;after stents in-dwelling feeding ability of 98%（59/60） patients has greatly improved, the quality of life improved significantly. Con-clusion Carotid stenting of the esophagus is simple, safe and effective to improve the esophageal stenosis and esophageal fistula of the patient′s quality of life and prolong life, which is a good method for treatment.