国产镍钛合金支架在食管良恶性狭窄应用中的进一步研究(附34例分析)

A further study on application of home-made nitinol stent in the treatment of benign and malignant esophageal strictures(report of 34 cases)

目的 :通过分析国产镍钛合金支架应用于 34例食管良恶性狭窄的结果 ,进一步评价其临床应用的可行性。方法 :本组共收集 34例 ,安放支架 38根 (男性 2 3例 ,女性 11例 ,年龄 4～ 76岁 ,平均 5 6岁 ) ,其中化学药物致食管狭窄 2例、贲门失驰症 6例、贲门 -食管癌术后吻合口狭窄 11例、食管 -贲门癌或食管癌术后复发 15例。全部支架置入均经胃镜在X线监视下进行。结果 :支架置入均获得成功 ,改善患者的进食能力 ,提高患者的生活质量 ,术后随访观察 1～ 16个月(平均 6个月 ) ,13例失去联系 ,其余 2 1例定期随访观察。迸一步证实使用国产镍钛合金支架治疗食管良恶性狭窄是安全有效的。结论 :①置入支架以喇叭形被覆支架临床效果最好 ,成功率高、副作用少。②置放支架的同时要根据不同的病因制定相应的治疗措施。

Objective:To evaluate the feasibility of a home made prototype nitinol stent in the treatmeat of benign and malignant esophageal strictures .Thirty four patients using the nitinol stent for supporting the esophageal were tested.Methods:38 home made nitinol stents were used in 34 cases(23 males and 11females,age from 4～76 and average of 56 years old)of benign and malignant esophageal strictures, of which 2 cases were caused by ingesting of alkali, 6 cases achalasia of the cardia, 6 cases anastomatic stenosis and 15 cases esophageal carcinoma. All stents were placed under the guidance of x ray by means of endoscope.Results:All stents were successfully placed without technical failure. Clinical symptoms and food intake abilities of all patients were improved. The mean follow up time in the successful cases was 6 months( range, 1～18 months). 13 cases were lost to follow up and the remaining 21 patients had regular follow up records. Home made nitinol stent is proved to be safe and effective in treatment of benign and malignant esophageal strictures.Conclusion:(1) Trumpet shaped stent with dacron knit fabric covered has the best clinical effect, high ratio of success and low side effect. (2)Correspoding treatment should be made acocording to different disease while placing stent.