暂时性覆膜支架治疗贲门失弛缓症47例回顾性分析  

The implantation of temporary covered-stent for the treatment of achalasia of cardia: a retrospective analysis

作　　者：朱守艳[1] 曾俊仁[1] 徐松[1] 甘井泉 袁寿红[1] 李惠英[1] 向述天[1] 

机构地区：[1]昆明昆明医科大学第四附属医院放射科,650021

出　　处：《介入放射学杂志》2013年第6期507-510,共4页Journal of Interventional Radiology

摘　　要：目的通过观察贲门失弛缓症患者行食管腔内金属支架置入术前、术后临床症状缓解率,支架回收后患者进食状态的变化、并发症的发生,评估暂时性覆膜支架治疗贲门失弛缓症的临床疗效,探讨其可行性和疗效。方法 47例贲门失弛缓患者,经食管钡餐造影确诊。支架选用国产暂时性覆膜支架,常规方法置入,置入2～3周后取出支架,复查食管钡餐。结果支架均一次性置入成功,47例患者术后吞咽困难均有不同程度缓解,由术前的Ⅰ～Ⅲ级得以改善,其中39例改善为0级,8例改善为Ⅰ级;支架置入后钡餐造影示食管直径均达到11 mm左右。结论暂时性覆膜支架治疗贲门失弛缓症是一种安全、有效、简单易行、症状即刻缓解、费用相对低廉的微创的治疗方法。Objective To assess the clinical efficacy of temporary covered-stent implantation for the treatment of achalasia of cardia by observing the clinical remission rate, the relief on taking food after retrieval of the stent, and the occurrence of complications, and to discuss the feasibility, safety and indications of temporary covered- stent implantation. Methods A total of 47 patients with achalasia were enrolled in this study. The diagnosis was confirmed by esophageal barium meal in all patients. Domestic temporary covered-stent was adopted, which was placed in the esophagus by using conventional technique. The stent was retrieved 2 or 3 weeks after implantation, and check-up examination with esophageal barium meal was performed to assess the clinical effectiveness. Results The stent was successfully placed in the esophagus with single procedure in all patients. After the implantation of the stent different degrees of improvement in dysphagia were obtained in all the 47 patients. The severity of dysphagia was reduced from preoperative Ⅰ～Ⅲ grade to postoperative 0 -Ⅰ grade, including 39 cases of grade 0 and 8 cases of grade Ⅰ. Postoperative esophageal barium meal examination showed that the diameter of the esophagus was up to 11 mm or so. Conclusion For the treatment of achalasia of cardia, the implantation of temporary covered-stent is safe, effective, minimally- invasive and technically- simple. The symptoms of dysphagia can be relieved instantly, and the patient needs not to stay in hospital,moreover, the medical cost is relatively lower.（J Intervent Radiol, 2013, 22： 507-510）

关 键 词：贲门失弛缓症 暂时性 覆膜支架 食管 

分 类 号：R571[医药卫生—消化系统]