暂时性蘑菇状内支架与经鼻经食管脓腔引流管置入治疗食管-胃吻合口瘘  

Temporary mushroom like covered stent placement with transnasal esophogeal fistula abscess drainage for gastroesophageal anastomotic fistula

作　　者：韩新巍[1] 吴刚[1] 赵高峰[2] 赵松[2] 高雪梅[1] 马南[1] 王艳丽[1] 

机构地区：[1]郑州大学第一附属医院放射科,450052 [2]郑州大学第一附属医院胸外科,450052

出　　处：《介入放射学杂志》2005年第2期156-159,共4页Journal of Interventional Radiology

摘　　要：目的　探讨暂时性蘑菇状覆膜内支架与经鼻经食管脓腔引流管置入治疗食管 胃吻合口瘘的疗效。方法　对 8例食管 胃吻合口瘘患者透视下 ,经鼻腔和食管向脓腔内置入引流管 ,负压抽吸脓液 ,再经食管置入蘑菇状覆膜内支架封堵瘘口。定时经引流管冲洗脓腔 ,适时复查脓腔造影 ,及时调整后退引流管的位置 ,直至引流管完全拔出 ;在置入术后 1个月左右 (约在引流管拔出后 1周 )取出支架。结果　 8例蘑菇状覆膜内支架和引流管置入技术操作全部成功 ,放置位置合适。经鼻经食管脓腔引流 14～ 2 1d ,脓腔消失 ,引流管完全拔出。置入术后 1个月内以介入技术顺利取出支架 ,复查造影瘘口均愈合 ,脓腔消失。结论　暂时性蘑菇状覆膜内支架与经鼻腔经食管脓腔引流管置入治疗食管 胃吻合口瘘 ,操作简单安全、无严重并发症、花费低、创伤小 。Objective To investigate the therapeutic effects on gastroesophageal anastomotic fistula with temporary placing covered stent of mushroom shape and transnasal drainage of gastroesophageal anastomotic abscess.Methods For 8 patients with gastroesophageal anastomotic fistula, under fluoroscopic guidance,the drainage tube was put into the abscess cavity through nasal cavity and esophageal fistula, then stent was implanted within the esophagus. The abscess cavity was aspirated and esophagogram was taken in suitable time.Retaining the drainage tube about one month and then the stent was withdrawn after one week of the taken out of the former. Results The drainage of abscess and stent placement were successful. The drainage tube was pulled out during 14-21 days after placement. The stent should be removed within one month. All fistulas were closed up and the abscesses disappeared.Conclusions It is a safe, efficient, complicationless, non-invasive method to treat gastroesophageal anastomotic fistula with temporary placing covered stent with mushroom shape and drainage of abscess through nasal cavity and esophagus.Temperary mushroom-like covered stent placement with transnasal gastroesophageal anastomotic abscess drainage is a safe efficient,complication-less non-invasive method used interventionally.

关 键 词：食管-胃吻合口瘘 置入治疗 经食管 暂时性 蘑菇 覆膜内支架 置入术后 引流管冲洗 严重并发症 负压抽吸 封堵瘘口 技术操作 放置位置 脓腔引流 介入技术 经鼻腔 拔出后 造影 复查 取出 

分 类 号：R735[医药卫生—肿瘤]