覆膜自膨式食管金属支架治疗食管恶性狭窄的疗效研究

A study of the curative effect of esophagealcovered selfexpanding metal stent on malignant esophageal stenosis

目的探讨覆膜自膨式食管金属支架在食管恶性狭窄中的临床疗效。方法选取食管恶性狭窄的患者58例,行覆膜自膨式食管金属支架置入治疗(38例)为支架组,球囊扩张术(20例)为球囊组。观察支架组和球囊组术后患者进食困难Stooler分级的改善情况、并发症及随访情况。结果(1)术后,支架组Stooler分级1、2级所占比例优于球囊组,支架组3、4级的改善情况优于球囊组,差异有统计学意义(P<0.05)。(2)并发症:支架组术后食管上段患者异物感明显9例,胃食管反流5例,患者出现支架移位2例,患者再狭窄1例,球囊组消化道出血1例,再发狭窄9例。支架组术后再发狭窄率低于球囊组,差异有统计学意义(P<0.01)。结论覆膜自膨式食管金属支架置入术可有效缓解食管癌性狭窄引起的吞咽困难,提高患者生存质量。

Objective To explore the clinical efficacy of esophagealcovered self-expanding metal stent(CSEMS)in the treatment of malignant esophageal stenosis.Methods A total of 58 patients with malignant esophageal stenosis were selected,among whom those treated with the implantation of esophageal CSEMS were the stent group(n=38)and those treated with balloon dilatation were the balloon group(n=20).The improvement of Stooler grading,the complications and the follow-up of the patients with eating difficulties in the stent group and the balloon group after operation were observed.Results(1)After operation,the proportion of Stooler grades 1 and 2 in the stent group was better than that in the balloon group,and the improvements of grades 3 and 4 were better than those in the balloon group.The differences were statistically significant(P<0.05).(2)Complications:After operation,there were 9 cases of obvious foreign body sensation in the upper esophagus,5 cases of gastroesophageal reflux,2 cases of stent displacement and 1 case of restenosis in the stent group.In the balloon group,there was 1 case of gastrointestinal hemorrhage and 9 cases of recurrent stenosis.The recurrence rate of stenosis in the stent group after operation was lower than that in the balloon group(P<0.01).Conclusion The implantation of esophageal CSEMS can effectively relieve dysphagia caused by esophageal cancerous stenosis and improve the quality of life for the patients.