食管良性狭窄金属支架置入术后合并症分析

Analysis of complications after placing fully covered self-expanding metal stent in patients with esophageal benign strictures

目的探讨食管良性狭窄全覆膜金属支架置入术后合并症的发生率及防治对策。方法收集首都医科大学附属北京友谊医院因食管良性狭窄全覆膜金属支架置入术患者的临床资料,对其合并症进行回顾性分析。结果食管良性狭窄全覆膜金属支架置入患者40例,术前均有不同程度的吞咽困难,术后吞咽困难均有所改善。其中支架移位或脱落12例,移位或脱落次数22次;支架上下缘组织增生9例(其中组织增生致食管管腔狭窄合并支架取出困难7例);消化道出血2例(其中1例因食管动脉活动性大出血,气道梗阻死亡);支架内食物梗阻并吞咽困难2例,呼吸困难不能耐受支架1例,食管气管瘘1例。结论全覆膜金属支架置入术治疗食管良性狭窄,合并症较多见,选择时应慎重考虑。

Objective To investigate the complications and prevention and control strategy after placing fully covered self-expanding metal stent for esophageal benign strictures. Methods A retrospective analysis was conducted in 40 patients with esophageal benign strictures after placing fully covered self-expanding metal stent. Results All cases with esophageal benign strictures had different levels of dysphasia,which was significantly improved after placing fully covered self-expanding metal stent. The main complications were： stent malapposition in 12 cases（ malapposition frequency is 22）,tissue overgrowth of stent in 9 cases（ among them,7 had difficult stentremoving）,upper gastrointestinal bleeding in 2 cases（ including one case who died of airway obstruction with esophageal arteries active bleeding）,food obstruction in 2 cases in stent combined with dysphagia,1 case failed to tolerate with the stent because of difficulty in breathing,and 1 case developed esophageal-tracheal fistula. Conclusion Complications are common in patients with esophageal benign strictures after placing fully covered self-expanding metal stent. Careful consideration is needed for this kind of diseases.