导丝导管交换技术在晚期食管癌支架植入中临床应用

Clinical Application of Guidewire and Catheter Exchange Technique in Advanced Esophageal Cancer with Stent Implantation

目的:评价内镜下导丝导管交换技术在食管支架治疗晚期食管癌中的安全性和有效性。方法:选取笔者所在医院2016年1月-2017年3月收治的晚期食管癌患者共45例,在X线透视(辅助)下,采用胃镜下导丝导管交换技术放置食管支架。观察支架放置成功率,术后吞咽困难分级,术后并发症发生情况。结果:45例患者均顺利放置食管支架,成功率100%;术后24 h吞咽困难分级为0~Ⅰ级;术后有6例患者出现胸骨后疼痛,对症处理后1周内改善。无消化道出血、穿孔、支架移位及死亡发生。结论:内镜下导丝导管交换技术治疗难治性晚期食管癌中具有较高的成功率,能够快速改善吞咽困难症状,且并发症发生率较低,值得应用推广。

Objective:To evaluate the safety and effectiveness of endoscopic guide wire and catheter exchange technique in the treatment of advanced esophageal cancer with stent implantation.Method:A total of 45 patients with advanced esophageal cancer admitted to the author’s hospital from January 2016 to March 2017 were selected,under X-ray fluoroscopy(assisted),esophageal stents were placed using guidewire and catheter exchange technology under gastroscope.The success rate of stent placement,postoperative dysphagia grading and postoperative complications were observed.Result:All 45 patients were successfully placed the esophageal stent with a success rate of 100%.The grade of dysphagia was grade 0-I 24 h after operation.After operation,6 patients had retrosternal pain,which was improved within 1 week after symptomatic treatment.No gastrointestinal bleeding,perforation,stent displacement or death occurred.Conclusion:Endoscopic guidewire and catheter exchange technology has a high success rate in the treatment of refractory advanced esophageal cancer,can quickly improve the symptoms of dysphagia,and the incidence of complications is low,which is worthy of application and promotion.