食管良恶性狭窄和瘘的食管支架治疗(附39例报告)  

Self-expanding metallic stent in the treatment of benign or malignant esophageal strictures and fistulas(a report of 39 cases)

作　　者：倪才方[1] 邵国良[1] 刘一之[1] 朱晓黎[1] 丁乙[1] 

机构地区：[1]苏州医学院附属第一医院放射科

出　　处：《中国临床医学影像杂志》1999年第1期38-40,共3页Journal of China Clinic Medical Imaging

摘　　要：目的：评价食管支架治疗食管良恶性狭窄和瘘的临床疗效，探讨食管支架放置成功的影响因素。材料与方法：对３９例严重吞咽困难患者放置了食管内支架，其中男２９例，女１０例，年龄３４～８３岁（平均６５岁）。食管恶性狭窄３１例，良性狭窄７例，单纯巨大食管胸腔瘘１例。在Ｘ线电视透视下先将狭窄段扩张至１０～１２ｍｍ，再推送、释放支架。采用国产可回收改良“Ｚ”型带膜支架和Ｍｅｄｉｔｅｃｈ公司的ＵＩｔｒａｆｌｅｘ带膜支架。随访时间１～９个月。结果：３９例所置支架均一次性到位，操作过程顺利，无术中并发症。所有患者吞咽困难症状明显改善，瘘口封闭。发生并发症１０例：食物嵌顿３例、胸骨后疼痛５例、支架移位２例。结论：食管支架放置操作简单、安全，是目前治疗良恶性食管狭窄及各种食管瘘比较理想的有效方法，放置成功的技术关键是术前正确的定位和选择合适的支架。Objective:To evaluate the clinical efficacy of self-expanding metallic stent(SEMS)in treatment of benign or malignant esophageal strictures and fistulas.Materials and Methods:38 esophageal strictures and one purely fistula the modified silicone coated giantuco-rosch Z stents or ultraflex stents were implanted under TV fluoroscopic guidance.Results:Successful stent placement was achieved in all cases at one stroke.Fistulas was completely sealed in five patients.All patients had made significant improvement in dysphasia.Complications occurred in five patients and included food impaction(n=2),stent migration(n=2)and chest pain(n=5).Conclusion:SEMS are a relatively safe and effective means in the management of benign or malignant esophageal strictures.

关 键 词：食道 吞咽困难 支架支架 治疗 食管狭窄 

分 类 号：R655.405[医药卫生—外科学]