食管支架置入术治疗上段食管癌性狭窄的临床疗效分析

Clinical Analysis of Esophageal Stent Implantation in the Treatment of Upper Esophageal Cancer Stenosis

目的探讨食管支架置入术治疗上段食管癌性狭窄的临床疗效分析。方法方便选取2014年3月—2017年3月在该院内科治疗的40例上段食管癌性狭窄患者随机分为两组,均采用胃镜定位下食管支架置入术治疗,对照组采用16 mm支架,观察组采用14 mm支架,比较两组患者的狭窄段直径变化、吞咽功能改善情况、并发症发生率。结果观察组治疗后狭窄段直径(13.43±3.82)mm明显少于对照组,两组间差异有统计学意义(P<0.05),且治疗后吞咽功能分级改善情况0级11例(55.00%)、Ⅰ级6例(30.00%)、Ⅱ级3例(15.00%)、Ⅲ级0例(0.00%)、Ⅳ级0例(0.00%)明显优于对照组,两组间差异有统计学意义(P<0.05);观察组胸骨后疼痛、支架移位/脱落、黑便、反流性食管炎、食管穿孔等并发症发生率30.00%明显优于对照组,两组间差异有统计学意义(P<0.05)。结论采用14mm支架行胃镜下食管支架置入术治疗上段食管癌性狭窄的疗效更佳,吞咽功能改善更明显,并发症发生率更低,具有积极的临床意义。

Objective This paper tries to investigate the clinical efficacy of esophageal stent implantation in the treatment of upper esophageal cancer stenosis. Methods 40 cases of patients with upper esophageal carcinoma stenosis treated in this hospital from March 2014 to March 2017 were conveniently selected and divided into two groups, all patients were treated with esophageal stent implantation under gastroscope, the control group was treated with 16 mm stent, and the observation group was treated with 14 mm stent, the changes of segment diameter, swallowing function and complication rate of the two groups were compared. Results In the observation group after treatment, the stricture was（13.43±3.82）mm in diameter, significantly less than the control group, the difference between the two groups was significant（P〈0.05）, and swallowing function of classification level 0 after treatment was 11 cases（55.00%）, Ⅰ level of 6 cases（30.00%）, Ⅱ level of 3 cases（15.00%）,Ⅲ grade of 0 cases（0.00%）, Ⅳ level of 0 cases（0.00%）, superior to control group, the difference between the two groups was significant（P〈0.05）; in the observation group, the retrosternal pain, bracket shift/peeling, and black, reflux esophagitis,esophageal perforation and other complications incidence was 30.00%, obviously better than the control group, the difference between the two groups was significant（P〈0.05）. Conclusion The use of 14 mm stent in the treatment of upper esophageal cancer stenosis with esophageal stent implantation under gastroscope is better, and the swallowing function improvement is more obvious, and the incidence of complications is lower, which has positive clinical significance.