覆膜食管支架在食管穿孔40例的应用分析

Application of covered esophageal stent applied in esophageal perforation (40 cases)

目的 探讨全覆膜食管支架治疗食管穿孔的效果和安全性。方法 采用全覆膜金属支架治疗医源性、肿瘤及异物所致食管穿孔40例,观察对其的治疗效果及并发症。结果 所有的食管穿孔患者一次性成功置入食管支架,术后均能顺利恢复进食;食管异物临时支架植入术后4天~1个月取出支架,复查胃镜及食管造影均明确穿孔愈合;3例食管癌并穿孔患者术后吞咽梗阻感明显缓解。主要并发症为术后胸痛及支架移位,6例（15%）出现支架移位,2例（5%）食管癌患者出现食物梗阻并支架移位。结论 全覆膜金属支架治疗食管穿孔,具有疗效确切,并发症少,安全有效等优点。

Objective To investigate the efficacy and safety of covered stent in treatment of esophageal perforation. Methods Observe and analyzed the effect and complications of covered metallic stent in esophageal perforation. In all of 40 cases, the most common causes were iatrogenic, esophageal cancer, and foreign body. Results All patients with esophageal perforation got successful esophageal stent placement. All of them recovered smoothly in eating. The stents were removed 4 days to 1 month later. Gastroscopy and angiography confirmed esophageal perforation has healed. 3 cases of esophageal cancer patients with dysphagia obviously relieved after stent placement. The main complications in stent and stent migration for chest pain after operation. 6 cases （15 %） of patients with stent displacement, while 2 cases （5 %） of esophageal cancer patients with food obstruction and stent displacement. Conclusion Treatment of esophageal perforation with covered metal stents endoscopically is effective and safe.