512例覆膜自膨式金属支架置入术治疗恶性食管狭窄的回顾性研究  

A retrospective study of 512 malignant esophageal strictures treated with covered self-expanding metal stent

作　　者：吴齐[1] 曹长琦[1] 李士杰[1] 张集昌[1] 

机构地区：[1]北京大学肿瘤医院内镜中心,100142

出　　处：《中华消化杂志》2012年第8期509-513,共5页Chinese Journal of Digestion

摘　　要：目的探讨覆膜自膨式金属支架置入术治疗恶性食管狭窄的临床效果。方法回顾性分析512例接受支架置入术者的临床资料，包括患者基本资料、吞咽困难缓解情况、并发症发生率及生存期。统计学处理采用t检验。结果512例患者共置人596枚支架。支架置人前后吞咽困难分级平均值差异有统计学意义[（3．4±0．6）级比（1．1±0．8）级，t=54．09，P〈0．01]。术后总体并发症发生率为14．5％（74／512），其中严重胸痛21例（4．1％）、出血16例（3．1％）、支架移位29例（5．7％）、食物嵌顿6例（1．2％）、瘘口未完全封堵2例（0．4％）。获得完整随访的238例患者生存期为30～1445d，平均218．9d。结论内镜下覆膜自膨式金属支架置人术可有效缓解恶性食管狭窄患者的吞咽困难症状。Objective To investigate the clinical efficacy of covered sel^expanding metal stent in the treatment of malignant esophageal stricture. Methods The clinical data of 512 patients accepted stent were retrospectively analyzed, which included patients＇ profiles, relief of dysphagia, incidence of complications and survival period. The data were analyzed by t test. Results A total of 596 stents were placed in 512 patients. There was significant difference in mean dysphagia score between before and after stent placement （grade 3.4±0. 6 vs grade 1.1±0.8, t=54. 09, P〈0. 01）. After the placement, the overall incidence of complications was 14.5%（74/512）, of which there were 21 cases of severe retrosternal pain （4. 1%）, 16 cases of bleeding （3. 1%）, 29 cases of stent displacement （5.7%~）, six cases of food impaction （1.2%）, two cases of fistula without completely blocked （0.4%）. The survival period of 238 patients with complete follow-up ranged from 30 to 1445 days, the mean time was 218.9 days. Conclusion Endoscopic covered self-expanding metal stent placement may effectively relieve dysphagia symptoms in patients with malignant esophageal stricture.

关 键 词：支架 食管肿瘤 食管狭窄 姑息疗法 吞咽障碍 

分 类 号：R735.1[医药卫生—肿瘤]