应用国产带膜金属内支架治疗食管瘘的初步研究  

A Preliminary Assessment of Homemade Covered Metallic Stent Implantation in the Treatment of Esophageal Fistula

作　　者：朱汉洲[1] 郑铨[1] 王兴华[1] 刘翠凤[1] 

机构地区：[1]江苏省靖江市人民医院介入放射科

出　　处：《临床放射学杂志》1999年第8期484-487,共4页Journal of Clinical Radiology

摘　　要：目的：评价国产带膜金属内支架治疗食管瘘的临床效果。材料与方法：本组３６例，其中食管气管瘘２１例，食管纵隔瘘７例，食管胃吻合口瘘８例。选用国产自膨式“Ｚ”型支架（ＣＥＳ）与镍钛热记忆合金支架。支架置入在Ｘ线电视监视下进行１６例，在胃镜下进行２０例，术后给予抗生素与止血药、镇静止痛药，１６例患者术后行放、化疗。结果：３６例支架置入术全部一次性成功，瘘口完全封闭，吞咽困难程度由术前平均４级降至１．５级，术后５～７天呼吸道症状消失，胸腔引流管拔除，所有患者均能进软食或半流质。２例内支架滑脱，２例食物嵌塞，１０例胸骨后疼痛。随访１个月～１年，平均６个月，１例发生纵隔脓肿，３例食管大出血和５例全身广泛转移死亡，其余均健在，内支架通畅。结论：应用国产带膜金属内支架治疗食管瘘是一种简单易行、安全可靠和经济有效的方法，术后配合放、化疗，效果更理想。Objective: To evaluate homemade cov ered metallic stent implantation in treating of esophageal fistula. Materials and Methods:Of 36 cases collected in this study, 21 were esophagotracheal fistula, 7 esophagomediastinal fistula and 8 esoph agogastric anastomostic fistula. Homemade selfexpanding Zstents and nick eltitanium heatmemory binary alloy stents were used in the treatment of esop hageal fistula. Stent implantation manipulation was monitored under fluoroscopy or gastroscopy. After the implantation 16 cases underwent chemotherapy and radio therapy. Results:Stent implantation was succeeded by single procedu re in all 36 cases, resulting in complete closing of the fistula. The severity o f dysphagia was reduced, on the average, from degree 4 to degree 1.5. The respir atory symptoms disappeared within 5～7 days and the thoracic drainage tube was w ithdrawn. All 36 patients could take soft or semiliquid diet. Stent slipping was seen in 2 cases, and food obstruction in 2 and retrosternal pain in 10. Patient s were followed up 1～12 months (mean 6 months). Mediastinal abscess formation d eveloped in one case, massive esophageal hemorrhage in 3 and death due to extens ive metastases occurred in 5. Conclusion: Implantation of homemade covered metallic st ent is a simple, safe and inexpensive procedure, and is effective for the treatm ent of esophageal fistula.

关 键 词：食管瘘 带膜金属内支架 置入术 介入放射学 

分 类 号：R816.4[医药卫生—放射医学]