食管球囊扩张并支架置入术治疗食管癌食管瘘的临床疗效观察

Clinical Curative Effect of Balloon Dilation Combined with Stent Placement on Esophageal Fistula in Esophageal Carcinoma

目的观察食管球囊扩张并支架置入术治疗食管癌食管瘘的临床疗效。方法选取2019年3月至2021年2月我科收治的70例食管癌并食管瘘患者为研究对象,根据治疗方式分为A组32例及B组38例,A组患者行球囊扩张并食管支架置入术后肠内营养,B组患者行单纯球囊扩张术后经胃管肠内营养支持,比较两组患者的手术疗效、生存期及术后并发症。结果术后1个月,A组患者的食管直径为(14.26±2.00)mm,大于B组的(12.74±1.24)mm;吞咽功能评分与食管癌患者生活质量评分为(0.65±0.94)分、(45.94±6.21)分,低于B组的(1.24±1.15)分、(51.31±9.62)分(P<0.05);A组患者的平均生存期(4.14±3.27)个月,高于B组的(2.68±1.97)个月(P<0.05);A组患者的胸骨后疼痛、严重肺炎及总术后并发症发生率为16.13%、2.70%、25.81%,低于B组的37.84%、18.92%、75.68%(P<0.05)。结论食管球囊扩张并支架置入术治疗食管癌食管瘘的临床疗效良好、并发症少,值得临床参考。

Objective To observe the clinical curative effect of balloon dilation combined with esophageal stent placement on esophageal fistula in esophageal carcinoma(EC).Methods 70 patients with EC complicated with esophageal fistula admitted to our department from March 2019 to February 2021 were selected,and divided into group A(32 cases)and group B(38 cases)according to the treatment methods.Group A was given enteral nutrition after balloon dilation combined with esophageal stent placement,group B was given enteral nutrition after balloon dilation.The surgical effect,survival time and postoperative complications were compared between 2 groups.Results One month after operation,the esophageal diameter in group A was(14.26±2.00 mm),larger than that in group B(12.74±1.24 mm);The scores of swallowing function and quality of life in group A patients were(0.65±0.94)and(45.94±6.21),lower than those of group B(1.24±1.15)and(51.31±9.62)(P<0.05).The mean survival time of patients in group A was(4.14±3.27 months),which was higher than that in group B(2.68±1.97 months)(P<0.05).The incidence of retrosternal pain,severe pneumonia and total postoperative complications in group A was 16.13%,2.70%,25.81%,lower than those in group B(37.84%,18.92%,75.68%,P<0.05).Conclusion Esophageal balloon dilatation with stent placement in the treatment of esophageal cancer esophageal fistula has good clinical efficacy,fewer complications,and is worthy of clinical reference.