肠镜下支架植入辅助治疗结肠癌性梗阻的临床疗效  

Clinical efficacy of endoscopic stent implantation in adjuvant treatment of colon cancer with intestinal obstruction

作　　者：廉波[1] 宋纯[1] 李鹏雷[1] 

机构地区：[1]辽宁省肿瘤医院,沈阳110040

出　　处：《中国肿瘤临床与康复》2013年第4期335-337,共3页Chinese Journal of Clinical Oncology and Rehabilitation

摘　　要：目的探讨肠镜引导下置入肠管支架辅助治疗结肠癌并梗阻的临床效果。方法选择47例左侧结肠癌致肠梗阻患者,对其中25例Ⅱ～Ⅲ期患者先行肠管支架置入解除梗阻,后择期行I期根治性结肠癌切除吻合术,对22例Ⅳ期患者置入永久性支架并局部穿刺予氟尿嘧啶缓释剂姑息疗法,观察支架置入成功率、并发症及序贯治疗效果。结果 (1)支架一次性置入成功率为95.7%,置入后4～6h肠梗阻症状解除;(2)择期手术组I期结肠癌根治术成功率为100%,根治术后发生吻合口漏1例(4.0%);(3)姑息治疗组置入支架后出现再次梗阻2例(9.1%),支架位移1例(4.5%),平均生存时间为(8.2±2.5)个月。结论肠镜引导下置入肠管支架治疗结肠癌性梗阻无需造瘘便能迅速改善肠梗阻症状,为择期手术者降低根治术并发症争取了先机;对姑息治疗者可缓解症状,提高生活质量。Objective The paper is to conduct an observation and discussion on clinical efficacy of endoscopic stent placement in adjuvant treatment of colon cancer with intestinal obstruction. Methods 47 admitted cases were selected as study objects, 25 patients belonging to TNM H -m period were applied stent placement to relieve obstruction firstly, and then underwent radical colon resection and anastomosis, 22 pa- tients belonging to TNM IV period were given permanent stent placement and sustained-release 5-fluorouracil palliative therapy, indicators of one-time success rate of stent placement, complications and sequential treat- ment effect were noted. Results （1）One-time success rate of stent placement was 95.7%, obstruction re- lieved 4-6h later after stent placement. （2）Success rate of stage I colon cancer radical resection in elective operation groups was 100%, 1 cases （4%） occurred anastomotic leakage after radical resection. （3）2 cases （9. 1% ） in palliative treatment group following stent placement occurred secondary obstruction, 1 cases （4. 5% ） occurred stent displacement, and mean survival time of palliative treatment group was （8. 2 ± 2. 5 ） months. Conclusions Endoscopic guided stents placement for treatment of colon cancer with intestinal ob- struction can rapidly alleviate obstructional symptoms without fistula, contribute to reduce complications for patients following radical resecton, also in favor of palliative treatment patients for remissing symptoms, im- proving quality of life.

关 键 词：内支架 结肠肿瘤 肠梗阻 1期根治术 姑息疗法 

分 类 号：R735.35[医药卫生—肿瘤]