食管良恶性狭窄及瘘的带膜内支架介入治疗

Intervention treatment of benign and malignant esophageal strictures with esophageal nitiol stents

目的 :研究应用带膜的镍钛合金金属内支架治疗食管的良恶性狭窄。方法 :共 6 0例患者 ,不能手术晚期食管癌 19例 ,食管癌放疗后引起的食管狭窄 2 0例 ,手术后吻合口狭窄 18例 ,手术后吻合口瘘 2例 ,腐蚀性食管炎 1例 ,4例合并食管 气管瘘或食管 纵隔瘘。所用器械包括 :6F猎人头导管 ,0 .0 35长 1 8m交换导丝 ,食管球囊导管 ,支架推送器和 5 0— 12 0mm镍钛合金金属支架。全部在电视透视下进行 ,局部口咽部麻醉。结果 :全部病例均获成功 ,其中一例患者因狭窄位置较高 ,支架置入后 48小时取出 ,术后进食良好。结论 :带膜的镍钛合金金属内支架对食管的恶性狭窄进行姑息性治疗是提高患者生存质量安全有效的方法 ;对手术后吻合口瘘与狭窄和食管 气管瘘或食管 纵隔瘘起到了较好的治疗作用。

Purpose:Fabric-covered esophageal nitiol stents were used for palliative treatment of benign and malignant esophageal strictures.Methods:60 cases had intraluminal stents intubation .The strictures were caused by advanced esophageal carcinoma ( n =19),post-radiotherapy stenosis ( n =20),post operative anastomotic stenosis( n =18), post-operative perforation( n =2),and ingestion of alkali( n =1),as well as 4 cases with esophageal-tracheal fistula or esophgomediastinum fistula. The instruments used were as follows :6F hunt catheter ,guide wire ,stent pusher ,balloom catheter and nitinol metallic stent in diameter from 50 mm to 120 mm . The intervention was performed under fluoroscopic guidance and local oropharyngeal anaesthesia. Results:All cases had their stents placed successfully. 1 case with high esophageal stricture had to have his stent removed after 48 hours,after-operation the patient could take quite well. Conclusions:Dacron knot fabric covered stent is safe and effective palliative treatment for esophageal stricture and anastomotic perforation or stenosis of some patients.