食道狭窄介入治疗的探讨  

A disseussion on Esophageal stricture treatment

作　　者：黄耀明[1] 潘抗镁[1] 

机构地区：[1]湖南省长沙医学院附属湘潭市二医院,411100

出　　处：《医学信息（下旬刊）》2010年第6期49-50,共2页Medical information

摘　　要：目的：探讨良、恶性食道狭窄各种治疗方法的临床应用价值。方法：2000年7月-2009年11月我院收治的食道良、恶性狭窄52例，其中手术切除病灶胸胃代食管11例、结肠代食管4例，安放镍钛合金不带膜支架4例，带膜支架31例，（其中可回收支架治疗良性食道狭窄2例）。安放支架共35例，在电透或胃镜下先送入软导丝、再换入硬导丝，必要时行珠囊扩张，再置入支架推送器，定位后释放支架。结果：应用各种方法治疗后病人吞咽梗阻症状改善均迭90％以上，支架安放均一次能安置成功，发现支架移位5例（图1），支架安放再狭窄再安放支架4例（图2），其中一例放置了3个支架，术后出血2例，顽固性疼痛1例。结论：早期食道癌性狭窄以手术治疗为首选方法，晚期食道癌狭窄安放支架是有效的姑息治疗方法，选用Z型支架支撑力强：网状型支架顺用性较佳，带放射粒子支架能同时对癌灶行安全剂量放射治疗，可缓解术后疼痛，胃造瘘术可用于补充营养，亦可延长生命，提高生存质量。食道良性狭窄可手术或选用可回收支架治疗。Objective To discuss the clinical value of various treatments of benign and malignant Esophageal stricture. Methods WE accepted 52 patients of Esophageal stricture from July 2000 to November 2009（benign and malignant）. 15 patients underwent Surgical resection ,of which 11 cases were directly removed and 4 cases were substituted with colon, we treated 35 cases with Nitinol stent （4 sets covered with film and 31 sets not ）. The Stem placement was done with videofluoroscopy. Results Patients after treatment improved by 90% or more. Coplieations included massive bleeding in 2 and severe headache in 1. Conclusion Early Esophageal stricture prefers operation and stent placement is the effective to advanced esophageal cancer narrow. Z--formed metallic stent supports well and mesh--formed stent is more applicable. Stent with radiative particle of safe doses can alleviate postoperative pain. On the whole, metallic stent seems to be an excellent palliative method for Esophageal stricture.

关 键 词：食道狭窄 粒子支架 食道气管瘘 

分 类 号：R616[医药卫生—外科学]