普通胃镜联合X线直视下胃十二指肠支架置放术的临床应用  

Clinical application of duodenal stent placement under gastroscopy and fluoroscopy

作　　者：汪平凡[1] 谢小西[2] 张永萍[1] 杨新叶[1] 陈加[1] 潘凤妹[1] 梁赛英[1] 

机构地区：[1]新昌县人民医院消化科,浙江312500 [2]新昌县人民医院放射科,浙江312500

出　　处：《影像诊断与介入放射学》2012年第1期46-48,共3页Diagnostic Imaging & Interventional Radiology

摘　　要：目的探讨经普通胃镜联合X线直视下金属支架置入术治疗胃出口、十二指肠恶性梗阻的临床价值。方法回顾分析22例胃出口、十二指肠恶性梗阻患者,经内镜钳道置入导丝,胃镜联合X线监视下置入并释放自膨式金属肠道支架。结果 22例患者共置入金属支架26例次,成功25例次,其中4例患者因肿瘤生长致支架堵塞或移位而再次置入;1例胰腺癌并十二指肠水平段梗阻梗阻患者支架放置不成功,成功率为96.15%。支架置入后内镜和透视造影检查示支架均定位准确、通畅。5例有少量出血,对症治疗效果良好;无消化道穿孔及其他支架置入相关等并发症。25例次支架放置24 h后梗阻症状得到缓解或消除;平均生存期为7.2个月。结论结合X线操作经内镜放置金属支架治疗胃出口、十二指肠恶性梗阻可提高置入成功率,具有简化操作、准确定位、减少相关并发症的优点。Objective To evaluate the clinical value of duodenal stem placement through the gastroscope combined with fluoroscopy. Methods 22 patients with malignant gastric outlet or duodenal obstruction were treated with 26 attempts of duodenal stent placement through the gastroscope combined with fluoroscopy. Results The success rate of the duodenal stent placement was 25/26 （96.15%） in 22 patients. Four patients required repeated stent placement due to stent obstruction or migration with tumor progression. The procedure was unsuccessful on 1 patient with pancreatic cancer because of obstruction of the third part of duodenum. After the procedure, all patients were examined by gastroscopy and fluoroscopy to check the position and patency of the stents. 5 patients had minor bleeding after the procedure. There was no other complication including gastrointestinal perforation. All patients showed relief of obstructive symptoms in 24 hours.The median survival was 7.2 months. Conclusion Stent placement through the gastroscope combined with fluoroscopy improves the success rate of relieving malignant gastric outlet or duodenal obstruction.

关 键 词：内镜 支架 胃出口 十二指肠 恶性梗阻 

分 类 号：R735[医药卫生—肿瘤]