两种姑息疗法治疗晚期食管癌疗效对比研究

COMPARISON RESEARCH ON TWO KINDS OF THE APPEASING TREATMENT FOR ADVANCED ESOPHAGEAL CARCINOMA

目的 :讨论采用两种姑息疗法治疗晚期食管癌患者食管狭窄程度、生存质量、生存期改善程度。方法 :经内镜留置带硅酮膜自膨式金属支架 (GRZS)治疗晚期食管癌患者 2 2例 ,其中 6例合并食管 -呼吸道瘘 ;经内镜留置导丝引导硅胶管MD - 46 10 0扩张治疗晚期食管癌患者 2 6例。结果 :该文GRZS组 2 2例治疗后食管阻塞程度由 (3.5± 0 .5 )级降至 (0 .85± 0 .35 )级 ,治疗 4周后体重增加 (7.5± 0 .5 )kg ,生存期 (10 .3±2 .1)月 ,6例食管 -呼吸道瘘 1次性治愈 ;MD组 2 6例治疗后食管梗塞程度由 (3 .15± 0 .38)级降至 (2 .15± 0 .6 9)级 ,治疗 4周后体重增加 (2 .2± 0 .7)kg ,生存期 (3 .7± 1.6 )月 ,留置GRZS在改善食管狭窄程度、生存质量、生存期均明显优于MD扩张治疗。结论 :经内镜留置带硅酮膜自膨式金属支架 (GRZS)治疗晚期食管癌是目前国际上广泛采用的姑息治疗方法 ,特别是对合并食管

Objective:Use two kinds of appeasing methods to treat advanced esophageal carcinoma patients,and compare the improvement of survival quality an curative effect of esophagostenosis. Method:Use GRZS which is retained by endoscope to treat advanced esophageal carcinoma patients of 22 cases,six of them have complicated esophago-pneogaster fistula;Retain the guide line-conductor by endoscope and guide silicagel tube MD-46100,use this kind of method to treat 26 patients of esophageal carcinoma.Results:After GRZS treatment,22 patients esophageal empraxis degree abates from grade 3.5±0.5 down to grade 0.85±0.35.Four weeks later,the body weight adds on 7.5±0.5kg,survival time achives to 10.3±2.1 months,six of them have complicated esophago_pneogaster fistula once only cure;After MD expanding treatment 26 patients esophageal empraxis degree abates from grade 3.15±0.38 down to grade 2.15±0.69.Four weeks later,the body weight adds on 2.2±0.7kg,survival time achives to 3.7±1.6 months.The GRZS treatment has obvious advantage over the MD expanding treatment in improving survival quality abating esophagostenosis degree and protracting survival time.Conclusions:Retaining the Gianturo-Rosch sillicon covered esophageal expandable metallic Z-stents(GRZS) by endoscope to treat advanced esophageal carcinoma that is a kind of popular palliative widely used in the world today,especially for complicated esophago-pneogaster fistulas.