内镜下自膨式金属支架植入术治疗食管恶性狭窄的效果研究

Effect Study of Endoscopic Self-expanding Metal Stent Implantation in Treatment of Malignant Esophageal Stricture

目的探讨内镜下自膨式金属支架植入术治疗食管恶性狭窄的效果。方法研究对象为我院102例食管恶性狭窄患者,于2010年08月至2017年08月间收治,所有患者入院后均予以内镜下自膨式金属支架植入术治疗,并观察分析其临床治疗效果。结果全部患者均顺利完成手术,成功植入支架。术后吞咽困难分级(3.6±0.6)级较术前(1.2±0.3)明显下降(P<0.05)。术后有15例患者发生并发症,其中5例疼痛,4例支架移位脱落,3例出血,1例反流性食管炎,2例瘘口封堵不全。术后有96例患者获得完整随访,其生存期为1个月-4年,平均生存期为(2.2±0.7)年。结论为食管恶性狭窄患者实施内镜下自膨式金属支架植入术治疗方案,可改善患者吞咽困难症状,且术后并发症少,安全性较高,值得临床重视。

Objective To investigate effect of endoscopic self-expanded metal stent implantation in treatment of malignant esophageal stricture. Methods Choose 102 cases malignant esophageal stenosis patients treated in our hospital from August 2010 to August 2017 as study subjects. All cases were treated with endoscopic self expanding metal stent implantation after admission, observe and analyze their clinical curative effects. Results All patients completed operation and implanted stent successfully. Postoperative dysphagia grade（3.6±0.6） was significantly lower than before operation（1.2±0.3）,（P〈0.05）. 15 cases occurred postoperative complications, including 5 cases of pain, 4 cases of stent displacement, 3 cases of bleeding, 1 case of reflux esophagitis and 2 cases of fistula occlusion. After operation, 96 cases were followed up fully, survival period was from 1 month to 4 years, with average survival time of（2.2±0.7） years. Conclusion Endoscopic self expanding metal stent implantation can improve dysphagia symptoms of malignant esophageal strictures patients, with fewer postoperative complications and high safety, which is worthy of clinical attention.