胃肠道狭窄是胃肠道系统各种疾病所伴发的一种常见并发症。胃肠道狭窄表现为胃肠道管腔的缩窄或闭塞,常可导致胃肠道梗阻,影响胃肠道的正常生理功能,严重者可危及病人的生命。过去,胃肠道狭窄多采用外科手术治疗或探条扩张治疗。自八十...胃肠道狭窄是胃肠道系统各种疾病所伴发的一种常见并发症。胃肠道狭窄表现为胃肠道管腔的缩窄或闭塞,常可导致胃肠道梗阻,影响胃肠道的正常生理功能,严重者可危及病人的生命。过去,胃肠道狭窄多采用外科手术治疗或探条扩张治疗。自八十年代以来,随着医疗器械的发展,介入放射学治疗技术的日臻成熟。对胃肠道狭窄多采用 X 线下球囊导管扩张术治疗。这种非手术治疗具有痛苦小、并发症少、费用低、操作容易且疗效明显等优点,深受各国和各专业医生的欢迎。展开更多
目的探讨带膜镍钛记忆合金网状支架在治疗晚期上胃肠道癌上胃肠道狭窄中的价值。方法本组33例,在日立TU-41 500 mA X线电视监视下,用交换导丝、Cobra导管引入超硬导丝,将支架置入病变段。结果33例共置入支架40枚,成功率100%。患者吞咽...目的探讨带膜镍钛记忆合金网状支架在治疗晚期上胃肠道癌上胃肠道狭窄中的价值。方法本组33例,在日立TU-41 500 mA X线电视监视下,用交换导丝、Cobra导管引入超硬导丝,将支架置入病变段。结果33例共置入支架40枚,成功率100%。患者吞咽困难及上胃肠道梗阻症状明显改善和解除,未出现上胃肠道穿孔、大出血或死亡等严重并发症。结论带膜镍钛记忆合金支架治疗晚期上胃肠道癌上胃肠道狭窄安全有效。展开更多
AIM:To determine the most effective intervention procedure by evaluation of mid and long-term therapeutic efficacy in patients of stricture of the gastrointestinal tract (GIT).METHODS:Different intervention procedures...AIM:To determine the most effective intervention procedure by evaluation of mid and long-term therapeutic efficacy in patients of stricture of the gastrointestinal tract (GIT).METHODS:Different intervention procedures were used to treat benign stricture of GIT in 180 patients including pneumatic dilation (group A, n=80), permanent (group B,n=25) and temporary (group C, n=75) placement of expandable metallic stents.RESULTS:The diameters of the strictured GIT were significantly greater after the treatment of all procedures employed (P<0.01). For the 80 patients in group A, 160 dilations were performed (mean, 2.0 times per patient).Complications in group A included chest pain (n=20), reflux (n=16),and bleeding (n=6). Dysphagia relapse occurred in 24 (30%) and 48 (60%) patients respectively during 6-and-12 momth follow-up periods in group A. In group B, 25 uncovered or partially covered or antireflux covered expandable metallic stents were placed permantly,complications included chest pain (n=10), reflux (n=15),bleeding (n=3), and stent migration (n=4), and dysphagia relapse occurred in 5 (20%) and 3 patients (25%) during the 6-and-12 month follow-up periods, respectively. In group C,the partially covered expandable metallic stents were temporarily placed in 75 patients and removed after 3 to 7 days via gastroscope, complications including chest pain (n=30), reflux (n=9), and bleeding (n=12), and dysphagia relapse occurred in 9 (12%) and 8 patients (16%) during the 6-and-12 month follow-up periods, respectively. The placement and withdrawal of stents were all successfully performed. The follow-up of all patients lasted for 6 to 96 months (mean 45.3±18.6 months).CONCLUSION:The effective procedures for benign GIT stricture are pneumatic dilation and temporary placement of partially-covered expandable metallic stents. Temporary placement of partially-covered expandable metallic stents is one of the best methods for benign GIT strictures in mid and long-term therapeutic efficacy.展开更多
AIM:To observe the frequent complications of stent placement for stricture of the gastrointestinal tract and to find proper treatment.METHODS:A total number of 140 stents were inserted in 138 patients with benign stri...AIM:To observe the frequent complications of stent placement for stricture of the gastrointestinal tract and to find proper treatment.METHODS:A total number of 140 stents were inserted in 138 patients with benign stricture of the gastrointestinal tract.The procedure was cornpleted under fluoroscopy in all of the patients.RESULTS:Stents were successfully placed in all the 138 patients.Pains occurred in 23 patients (16.7%),slight or dull pains were found in 21 patients and severe chest pain in 2 respectively.For the former type of pain,the patients receivedonly analgesia or even no treatment,while peridural anesthesics was conducted for the latter condition. Reflux occurred in 16 of these patients (11.6%) after stent placement.It was managed by common antireflux procedures. Gastrointestinal bleeding occurred in 13 patients (9.4%),and was treated by hemostat.Restenosis of the gastrointestinal tract occurred in 8 patients (5.8%),and was apparently associated with hyperplasia of granulation tissue.In 2 patients,the second stent was placed under X-ray guidance.The granulation tissue was removed by cauterization through hot-node therapy under gastroscope guidance in 3 patients,and surgical reconstruction was performed in another 3 patients. Stent migration occurred in 5 patients (3.6%),and were extracted with the aid of a gastroscope.Food-bolus obstruction was encountered in 2 patients (1.4%) and was treated by endoscope removal.No perforation occurred in all patients.CONCLUSION:Frequent complications after stent placement for benign stricture of the gastrointestinal tract include pain,reflux,bleeding,restenosis,stent migration and food-bolus obstruction.They can be treated by drugs,the second stent placement or gastroscopic procedures according to the specific conditions.展开更多
文摘胃肠道狭窄是胃肠道系统各种疾病所伴发的一种常见并发症。胃肠道狭窄表现为胃肠道管腔的缩窄或闭塞,常可导致胃肠道梗阻,影响胃肠道的正常生理功能,严重者可危及病人的生命。过去,胃肠道狭窄多采用外科手术治疗或探条扩张治疗。自八十年代以来,随着医疗器械的发展,介入放射学治疗技术的日臻成熟。对胃肠道狭窄多采用 X 线下球囊导管扩张术治疗。这种非手术治疗具有痛苦小、并发症少、费用低、操作容易且疗效明显等优点,深受各国和各专业医生的欢迎。
文摘目的探讨带膜镍钛记忆合金网状支架在治疗晚期上胃肠道癌上胃肠道狭窄中的价值。方法本组33例,在日立TU-41 500 mA X线电视监视下,用交换导丝、Cobra导管引入超硬导丝,将支架置入病变段。结果33例共置入支架40枚,成功率100%。患者吞咽困难及上胃肠道梗阻症状明显改善和解除,未出现上胃肠道穿孔、大出血或死亡等严重并发症。结论带膜镍钛记忆合金支架治疗晚期上胃肠道癌上胃肠道狭窄安全有效。
基金Supported by the National Key Medical Research and Development Program of China during the 9~(th) Five-year Plan Period,No.96-907-03-04 Shanghai Nature Science Funds,No.02Zl314073 Shanghai Medical Development Funds,No.00419
文摘AIM:To determine the most effective intervention procedure by evaluation of mid and long-term therapeutic efficacy in patients of stricture of the gastrointestinal tract (GIT).METHODS:Different intervention procedures were used to treat benign stricture of GIT in 180 patients including pneumatic dilation (group A, n=80), permanent (group B,n=25) and temporary (group C, n=75) placement of expandable metallic stents.RESULTS:The diameters of the strictured GIT were significantly greater after the treatment of all procedures employed (P<0.01). For the 80 patients in group A, 160 dilations were performed (mean, 2.0 times per patient).Complications in group A included chest pain (n=20), reflux (n=16),and bleeding (n=6). Dysphagia relapse occurred in 24 (30%) and 48 (60%) patients respectively during 6-and-12 momth follow-up periods in group A. In group B, 25 uncovered or partially covered or antireflux covered expandable metallic stents were placed permantly,complications included chest pain (n=10), reflux (n=15),bleeding (n=3), and stent migration (n=4), and dysphagia relapse occurred in 5 (20%) and 3 patients (25%) during the 6-and-12 month follow-up periods, respectively. In group C,the partially covered expandable metallic stents were temporarily placed in 75 patients and removed after 3 to 7 days via gastroscope, complications including chest pain (n=30), reflux (n=9), and bleeding (n=12), and dysphagia relapse occurred in 9 (12%) and 8 patients (16%) during the 6-and-12 month follow-up periods, respectively. The placement and withdrawal of stents were all successfully performed. The follow-up of all patients lasted for 6 to 96 months (mean 45.3±18.6 months).CONCLUSION:The effective procedures for benign GIT stricture are pneumatic dilation and temporary placement of partially-covered expandable metallic stents. Temporary placement of partially-covered expandable metallic stents is one of the best methods for benign GIT strictures in mid and long-term therapeutic efficacy.
基金Supported by the National Key Medical Research and DevelopmentProgram of China during the 9~(th) Five-year Plan Period,No.96-907-03-04Shanghai Nature Science Funds,No.02Zl314073Shanghai Medical Development Funds,No.00419
文摘AIM:To observe the frequent complications of stent placement for stricture of the gastrointestinal tract and to find proper treatment.METHODS:A total number of 140 stents were inserted in 138 patients with benign stricture of the gastrointestinal tract.The procedure was cornpleted under fluoroscopy in all of the patients.RESULTS:Stents were successfully placed in all the 138 patients.Pains occurred in 23 patients (16.7%),slight or dull pains were found in 21 patients and severe chest pain in 2 respectively.For the former type of pain,the patients receivedonly analgesia or even no treatment,while peridural anesthesics was conducted for the latter condition. Reflux occurred in 16 of these patients (11.6%) after stent placement.It was managed by common antireflux procedures. Gastrointestinal bleeding occurred in 13 patients (9.4%),and was treated by hemostat.Restenosis of the gastrointestinal tract occurred in 8 patients (5.8%),and was apparently associated with hyperplasia of granulation tissue.In 2 patients,the second stent was placed under X-ray guidance.The granulation tissue was removed by cauterization through hot-node therapy under gastroscope guidance in 3 patients,and surgical reconstruction was performed in another 3 patients. Stent migration occurred in 5 patients (3.6%),and were extracted with the aid of a gastroscope.Food-bolus obstruction was encountered in 2 patients (1.4%) and was treated by endoscope removal.No perforation occurred in all patients.CONCLUSION:Frequent complications after stent placement for benign stricture of the gastrointestinal tract include pain,reflux,bleeding,restenosis,stent migration and food-bolus obstruction.They can be treated by drugs,the second stent placement or gastroscopic procedures according to the specific conditions.
