食管支架治疗食管恶性狭窄的临床应用研究  

Study of clinical application of the covered stent in the treatment of esophageal diseases

作　　者：王庆良[1] 郭依廷 刘海燕[3] 

机构地区：[1]山东大学齐鲁医院放射科,山东济南250012 [2]山东枣庄市妇幼保健院放射科,山东枣庄277102 [3]山东泰山疗养院放射科,山东泰安271000

出　　处：《医学影像学杂志》2005年第12期1058-1061,共4页Journal of Medical Imaging

摘　　要：目的:回顾性分析食管支架放置对恶性食管疾病的治疗并由此带来的生存质量的提高、生存期的延长以及食管支架放置过程中、术后出现的并发症及其相关因素。方法:利多卡因行口腔及咽喉部麻醉,置开口器,透视下将超滑导丝与8F大腔导管送入食管内,撤出导丝,经导管行食管造影标记定位病变区。导丝及导管进入胃内,置换不折导丝,部分病人行预扩张选择合适支架,沿导丝送至病变部位,透视监视下缓慢释放。结果:本组326例食管疾病患者共放置369枚食管支架,343枚支架一次放置成功,所有支架释放后即刻位置满意者337枚。放置支架后患者的一般状况很快得到好转。并发症有疼痛、再狭窄、支架移位、胃内容物反流、出血、支架嵌顿填塞、打嗝,其中1例于放置支架后30h因大出血死亡。结论:对于重度吞咽困难而又失去手术机会或拒绝接受手术治疗的食管癌患者,经口腔放置食管支架是一种操作安全可靠、微创、简单易行、见效快、费用相对低廉的治疗方法。Objective： To evaluate the clinical efficacy and complications of the covered esophageal stents in the treatment of malignant esophageal stricture.Methods：An aerosol spray for topical anesthesia （spray and gel lidocaine） was applied to the mouth and pharynx,an 8F big lumen catheter with a super smooth guidewire was passed into the esophagus perorally. The guidewire was withdrawn and some water-soluble contrast agent was injected while pulling the catheter upward to show the range of the lesion to verify the diagnosis made previously. Then the location of the lesion in the esophegus was marked. The super stiff guidewire was exchanged. Some patients was dilated. Asuitable stem was displaced under fluoroscopic guidance carefuUy. Results：369 stents were placed in 326 patients. 343 stents （92.9%） were placed one time. It was satisfactory of immediate location in 337 stents （91.3%）. Patients condition improved in a short time. In our group, complications included chest pain, restenosis, stent migration, esophagus reflux, bleeding. One patient died of massive bleeding, stent blockage and eructation. Conclusion： Esophageal stent placement was a safe, simple and relatively cheap and dependable management with microtrauma for those who had lost the chance of surgical resection or refused to undergo operation.

关 键 词：食管狭窄 支架 覆膜 介入治疗 

分 类 号：R571.1[医药卫生—消化系统] R815[医药卫生—内科学]