内镜下射频联合记忆合金支架治疗食管贲门重度癌性狭窄效果观察

Treatment of severe carcinous stricture of cardia with radiofrequency and self-expanding metal stent under endoscopy

目的 探讨射频在食管贲门癌重度狭窄（Ｓｔｏｏｅｒ分级ＩＶ级）支架术前及支架术后再度癌性狭窄的治疗作用。方法 随机选２４例食管贲门癌ＩＶ级狭窄常规方法安置支架失败的患者，术前通过射频治疗使病变狭窄处有一直径约０．２ｃｍ～１．１ｃｍ的通道，再按胃镜直视下放置记忆合金支架。对１０例支架术后癌性再狭窄患者，用射频治疗消除新生组织至食管再通。结果２４例患者均一次安置支架成功，无严重并发症．１０例支架术后再度癌性狭窄获再通。结论 内镜下射频联合记忆合金支架治疗食管贲门重度癌性狭窄，成功率１００％。并使用射频治疗解除支架术后癌性再狭窄，提高支架术的远期疗效。

Objective To study the effect of radiofrequency(RF) on treating esophageal cardiac carcinoma cardinome before and after installation of self - expanding metal stent ( SEMS) Methods Twenty four cases of severe carcinous cardiac stricture( IV grade) failed in routine SEMS therapy were randomly treated by SEMS under endoscopy after the stricture being ablated by RF to obtain a diameter of 0. 2cm to 1. 1cm. Ten cases of recurrent stricture after initial SEMS were treated by RF. Results SEMS was installed successfully in all of the 24 cases without any severce complication. Ten cases of recurrent stricture after SEMS treatment were satisfacterily improved by RF therapy. Conclusion the effective rate of RF end SEMS combined treatment of severe carcinous cardiac stricture is 100% RF therapy may releive the recurrent carcinous stricture after SEMS and improve the long term effectireness of SEMS.