金属内支架在消化道恶性梗阻及瘘中的应用  

The metallic stent as a treatment of malignant obstruction of the digestive tract and fistula

作　　者：张进荣 吴小燕 

机构地区：[1]山西省汾阳医院影像科,山西032200

出　　处：《当代医学》2009年第23期461-463,共3页Contemporary Medicine

摘　　要：目的探讨置入金属内支架在消化道恶性梗阻及瘘中的应用价值。方法在DSA监视下对43例消化道恶性梗阻及瘘患者采用记忆钛镍合金加膜内支架治疗,经口腔或肛门将支架置放于梗阻或瘘口部位,根据进食进水及排便等情况来评价疗效。结果食管支架置入后吞咽困难症状由治疗前的平均2.9级到治疗后的1.1级,其中治疗后0级14例(37.83%)I级17例(45.94%)II级6例(16.21%)总有效率100%;胃、十二指肠支架置入后瘘口均被封堵;结、直肠支架置入后肠梗阻症状即刻解除。术后胸部疼痛4例(10.25%),支架移位2例(4.64%),黑便1例(2.32%),再狭窄1例(2.32%),结论应用内支架置入术是治疗消化道恶性梗阻及瘘的有效方法,操作简单,重复性强,安全性高,值得临床推广应用。To explore the clinical value of the metallic stent as a treatment of malignant obstruction of the digestive tract and fistula. Methods The total 43 patients suffered with malignant obstruction of digestive tract and fistula were treated with memory titanium nickel alloy, covered stents. All the procedures were performed under DSA guidance. Inserted via the oral anal access, the stents were placed at the sites of obstructions or the fistulas. The clinical efficiency was assessed by function of swallowing or defecation in follow up. Results After the esophageal stents were placed, the level of dysphagia symptoms was improved from 2.9 before treatment to 1.1 after treatment, of which 0 was seen in 14 patients（37.83%）; I in 17patients（45. 94%）; and I in 6 patients（16.21%）. The total effective rate was 100%. The fistulas were covered after a stent was placed in gastroduodenal. Immediate relief of obstruction was observed in colorectal. Postoperative chest pain was seen in 4 cases （10.25%）; displacement of stents in 2 cases （ 4.64%）; melena in lcase （2.32%） and restenosis in lcase （ 2.32% ）. Conclusion It is an effective, easy and safe method to treat malignant obstruction of the digestive tract and fistula using metallic stent, and it is worthy of clinical application.

关 键 词：消化道恶性梗阻 瘘 内支架置入 并发症 

分 类 号：R735[医药卫生—肿瘤] R735.105[医药卫生—临床医学]