食管良恶性狭窄支架成形术的临床作用

Clinical application of expandable stent for benign and malignant esophageal obstruction

目的 探讨镍钛记忆合金支架在食管癌性梗阻、食管吻合口狭窄、吻合口瘘、贲门失弛缓症中的临床应用价值。 方法 对 2 2例食管良恶性狭窄者 ,采用X线电视定位 ,经口插管技术 ,将金属支架准确送入狭窄段 ,支架膨开后 ,重新建立食物通道。 结果 置管后 ,吞咽困难程度由术前平均 3 1级改善为 1 2级。 2例吻合口瘘 ,1例食管气管瘘得到封堵。随访1～ 12个月 ,3例死于肿瘤恶液质 ,1例死于消化道大出血 ,其余 18例尚在随访中。 结论 食管支架成形术是治疗食管良恶性狭窄、吻合口瘘可选择方法之一 ,对提高患者生活质量 ,延长生命发挥着重要作用。

Objective To study the clinical application of self-expanding nitinol stent in benign and malignant esophageal obstruction as well as in postoperative anastomotic stenosis and anastomotic leakage. Methods 22 cases of benign or malignant esophageal stenosis were treated by placing metallic stents inserted into the stenosis segment through per-oral intubation under the fluoroscopic guidance. Results The degreee of dysphagia was improved, Stooler′s staging of dysphagia was down from 3.1 preoperatively to 1.2 postoperatively. 2 cases of anastomotic leakage and 1 case of esophagorespiratory fistula were cured. All have been followed up for one to twelve months. 3 cases died with carcinoma cachexia and one succumbed to severe hemorrahage of digestive tract. The other 18 cases are still followed up. Conclusions Placement of esophageal expandable stent is one of the ideal methods to treat benign and malignant esophageal stenosis and anastomotic leakage. It can also play an important role in the improvement of the patients' life quality and prolongation of life.