内镜下支架置入术治疗消化道狭窄273例  

Endoscopic stent placement for stenosis of the digestive tract:an analysis of 273 cases

作　　者：孙杰[1] 刘文天[1] 王邦茂[1] 张庆瑜[1] 吕宗舜[1] 

机构地区：[1]天津医科大学总医院消化科,天津市300052

出　　处：《世界华人消化杂志》2011年第6期644-649,共6页World Chinese Journal of Digestology

摘　　要：目的:探讨内镜下支架置入术治疗消化道狭窄的临床疗效、安全性及患者的治疗满意度.方法:273例消化道狭窄患者,食管贲门狭窄242例,胃十二指肠狭窄24例,结肠直肠狭窄7例;恶性狭窄256例,良性狭窄17例,所有患者均有不同程度的消化道梗阻症状,其中15例合并食管气管瘘,均行内镜直视下支架置入术,术后观察临床疗效和不良反应,并进行治疗满意度调查.结果:所有患者均成功置入支架,266例(97.4%)消化道梗阻症状缓解,15例(100%)食管气管瘘者瘘口得到有效封堵.156例(57.1%)于架置入术后出现不良反应,主要为胸(腹)痛87例(31.9%),出血39例(14.3%),其中1仅例食管恶性狭窄者术后当天因消化道大出血死亡.43例(15.8%)出现再狭窄.256例(93.8%)对治疗表示满意.结论:内镜下支架置入术是一种治疗消化道狭窄、解除梗阻、封堵瘘口非常有效的治疗方法,手术安全性较高,使患者获得较高的治疗满意度.AIM:To assess the safety,efficacy and patient satisfaction of endoscopic stent placement for stenosis of the digestive tract.METHODS:A total of 273 patients with stenosis of the digestive tract were included in the study,of whom 242 had esophageal and cardial stenosis,24 had gastroduodenal stenosis,7 had colorectal stenosis;256 had malignant stenosis,17 had benign stenosis;273 had gastrointestinal obstruction symptoms;15 suffered from esophageal fistula.Endoscopic placement of stents was performed in all patients.The safety,efficacy and patient satisfaction were evaluated after stent placement.RESULTS:Stents were successfully placed in all patients(100%).Gastrointestinal obstruction symptoms were alleviated in 266 patients(97.4%).Esophageal fistula was successfully closed in 15 patients(100%).Stent-related adverse effects occurred in 156 patients(57.1%),mainly including chest(abdominal) pain in 87 cases(31.9%) and bleeding in 39 cases.Only one patient with malignant esophageal stenosis died of gastrointestinal bleeding after esophageal stent placement.Re-stenosis was detected in 43 patients(15.8%).Approximately 93.8% of patients were satisf ied with the treatment.CONCLUSION:Endoscopic stent placement is an effective and relatively safe treatment for stenosis of the digestive tract and esophageal f istula.The rate of treatment satisfaction is high.

关 键 词：支架 治疗 消化道狭窄 

分 类 号：R57[医药卫生—消化系统]