自膨式金属食管支架的临床应用

Self-expandable Metal Stents for the Treatment of Patients with Dysphagia

目的 :探讨自膨式食管支架 (Self-ExpandingMetalStent,SEMS)治疗吞咽困难患者的临床效果、适应症及并发症。方法 :收集我院安置的食管支架患者 32例之临床相关资料。以 5分法记录支架安置前后吞咽困难程度。并发症出现的时间以 30天为界。结果 :吞困难评分由安置前的 3 43降为安置后的 1 15 (P <0 . 0 5 )。食管 支气管瘘全部痊愈 (4例 )。 6例患者支架安置后发生了早期并发症 ;出血 (2例 )、胸骨后疼痛不适 (4例 )。 1例发生了远期并发症 :支架移位。结论 :自膨式食管支架安置能迅速、有效地改善吞咽困难 ,提高患者生活质量 ,延长生存期限。是否适用于良性食管梗阻尚有争议。严格掌握适应症及新型食管支架的问世 。

Objective:To investigate the clinical efficacy,indications and complications of self-expandable metal stents(SEMS)in patients with dysphagia.Methods:Analysis included 32 patients who received SEMS placement in our hospital.Dysphagia before and after stents placement was scored on a 5-point scale.Early(less than 30 days)and late complications(more than 30 days)were observed.Results:The dysphagia score after stent placement improved from a mean of 3 43 to 1 15.Fistulas sealed in all 4 cases.Early complications occurred in 6 cases:bleeding(2 cases)and pain(4 cases).Late complications developed in one case:stent migration.Conclusion:Insertion of SEMS in patients with dysphagia significantly improved dysphagia quality of life,and prolong life expectancy.There is still controversy about its employment in patients with benign dysphagia.Decrease of complications can be expected if indications are strictly controlled and new stents come into being.