食道恶性狭窄的内支架治疗  

Appllication of Stents Placement in the Treatment of Malignant Esophageal Strictures

作　　者：任伟新[1] 陈鹏[1] 马骏[1] 沈阳[2] 王慧民[2] 

机构地区：[1]新疆医科大学第一附属医院DSA室,乌鲁木齐市8300002 [2]新疆兵团医院放射科,乌鲁木齐市830002

出　　处：《中国医学影像学杂志》1999年第3期208-210,共3页Chinese Journal of Medical Imaging

摘　　要：目的：探讨用食道内支架技术治疗食道恶性狭窄的疗效、技术要点及并发症。材料和方法：４６ 例中，男４０ 例，女６ 例，年龄５６ ～８０ 岁（ 平均６４ 岁） 。其中食道癌３９ 例，贲门癌２ 例。食道癌或贲门癌术后吻合口肿瘤复发５ 例。选用带膜支架３４ 例，不带膜支架１２ 例。均在Ｘ 线监视下，经口腔植入内支架。结果：４６ 例中４４ 例植入成功。４４ 例植入内支架的患者吞咽困难明显改善。随访６ ～２４ 个月，平均生存期８ 个月，最长２０ 个月。２ 例在２ 个月内肿瘤向腔内生长致再狭窄，再植入内支架症状改善。１ 例内支架植入后２ 个月发生移位，经手术取出，再植入。１ 例内支架植入１ 周后死亡。结论：食道内支架是治疗食道恶性狭窄的有效方法；吻合口或贲门癌所致狭窄以选不带膜支架为佳；配合必要的化、放疗可减少再狭窄，并且可提高生存期。Purpose:To assess the effective,technique,and complication of esophageal stent for treatment of malignant esophageal strictures.Materials and methods:Esophageal stents were used for treatment of malignant esophageal strictures in 46 patients (40 men,6 women,aged 56～80).The strictures were caused by esophageal carcinoma(n=39),cardia carcinoma(n=2),and anastomotic stenosis(n=5).Two type stent were chosen (covered-stent in 34 cases,uncovered-stent in 12 cases)All patients were treated by placing esophageal stent under fluoroscopic guidance.Results:Successful stent placement was achieved in all cases.Dysphagia were relieved in 44 of 46 cases.The followed-up period was from 6 months to 24 monthes.The average survival time was 8 months(the longest 20 month).Symptoms of two patients with carcimoma recurrent stenosis within two months were relieved by replacing stent.One patient with stent migrating after two months was placed the stent again.One patient with unknown reasons died after a week.Conclusion:The esophageal stent is an effective treatment for malignant esophageal strictures.The uncover stent is selected firstly to treat the anatomotic stenosis.The survival time of the patients with esophageal stent is lasted and re-stricture decreased in combination with chemotherapy and radiation therapy.

关 键 词：食道狭窄 内支架 食管癌 贲门癌 

分 类 号：R655.405[医药卫生—外科学] R735.06[医药卫生—临床医学]