老年患者食道狭窄、食管胸腔瘘的记忆合金支架治疗  

Observation of Memorial Alloying Stents for Esophago-Pleural Sac Fistula and Lemostenosis

作　　者：刘涛[1] 冯凯祥[1] 林凤琼[1] 邓莉[1] 

机构地区：[1]四川省绵阳市中心医院消化内科,四川绵阳621000

出　　处：《中国现代医生》2008年第7期32-33,共2页China Modern Doctor

摘　　要：目的了解老年患者胃镜下置入记忆合金支架治疗食管贲门狭窄、食管胸腔瘘的治疗效果。方法40例老年患者,年龄70～87岁;平均(76.025±5.280)岁;病程半个月～10个月,平均病程3.5个月。其中食管18例(1例为肺癌食管转移),食管下段贲门4例,食管胃吻合口7例,11例食管胸腔瘘(8例为食管自发性破裂所致),经胸腔引流管及食道泛影葡造影确诊食管胸腔瘘。进行胃镜下置入记忆合金支架治疗食管贲门狭窄、食管胸腔瘘,并评价治疗前后的临床效果、吞咽困难评分。结果术前吞咽困难3级24例,4级5例;食管胸腔瘘进食后胸腔引流增多、发热,患者无法进食,营养障碍明显;术后1周吞咽困难评分均为2级～1级。随访2个月,无支架移位、脱落和严重并发症出现。3d后患者食管胸腔瘘消失,进食后胸腔无引流增多,发热明显好转。结论Ni-Ti合金支架治疗老年患者食管贲门狭窄、食管胸腔瘘,临床疗效较好,安全性较高。Objective To learn the therapeutic efficacy of inserting memorial alloying stents on senile patients with esophageal stricture and esophago-pleural sac fistula under gastroscope. Methods 40 senile patients from 70 to 87 years old（76.025 ± 5.280 of the average age）,with the course of disease from half a month to 10 months（ 3.5 months of the average course ） were chosen. Of the 40 cases, 18 were esophageal stricture（one of them was lung cancer esophagus metastasis）,4 were lower esophagus and cardial stricture,7 were esophagogastric anastomotic stenosis, the other 11 were esophago- pleural sac fistula（8 of them were caused by spontaneous esophageal rupture ） and were finally diagnosed by intrathoracic drain tube and esophageal gastrografin Imaging. All the 40 patients were inserted by the memorial alloying stent under gastroscope, and the chnical effect and dysphagia score were evaluated before and after the treatment. Results 29 cases with dysphagia score 3 to 4 grade preoperatively,were scored 2 to 1 grade one week after the stent insertion. Follow-up time was 2 months,and there was no stent slipping,shedding or serious complication appeared. The clinical symptoms of patients with esophago-pleural sac fistula were relieved in the all cases, resulting in the vanishing of the fistula after 3 days later of the stent insertion. Food intake ability of all them was improved without chest drainage increasing or feverscence after eating. Conclusion The Ni-Timemorial alloying stent is a safe and effective method for the treatment of esophageal preventricular stenosis and esophago-thoracic fistula in senile patients.

关 键 词：记忆合金支架 食道狭窄 食管胸腔瘘 

分 类 号：R655.4[医药卫生—外科学]