经内镜放置幽门金属支架联合氩气刀消瘤术对恶性胃出口梗阻的治疗27例  

Treatment of malignant gastric outlet obstruction by endoscopic metal stent implantation with argon plasma coagulation: Analysis of 27 cases

作　　者：顾剑锋[1] 丁威[1] 胡健[1] 李朝燕[1] 李明峰[1] 

机构地区：[1]中国人民解放军第455医院消化内科,上海市200052

出　　处：《世界华人消化杂志》2014年第29期4482-4486,共5页World Chinese Journal of Digestology

摘　　要：目的:评价经内镜放置幽门金属支架及联合氩气刀消瘤术对恶性胃出口梗阻的治疗价值.方法:对2010-02/2013-11中国人民解放军第455医院消化内科54例恶性胃出口性梗阻的患者施行金属支架置入及支架联合氩气刀消瘤术.随机分为对照组及治疗组,对照组27例为单纯金属支架置入,治疗组27例为金属支架联合氩气刀消瘤术.结果:27例患者进行幽门金属支架置入联合氩气刀消瘤术的成功率为100%(27/27).术后24 h可进流食和软食.并发症:疼痛共6例,其中对照组4例,治疗组4例,对照组有3例术后2 mo发生再狭窄,治疗组有1例在术后4.3 mo发生再狭窄;无出血及穿孔.对照组术后6 mo后死亡2例.治疗组患者在症状、饮食及生活质量均优于对照组.结论:内镜金属支架置入联合氩气刀消瘤术治疗恶性胃出口梗阻是一种安全有效的方法.AIM： To investigate the efficacy and safety of endoscopic self-expandable metal stent implantation with argon plasma coagulation in the treatment of malignant gastric outlet obstruction.METHODS： Clinical data for 54 patients with malignant gastric outlet obstruction diagnosed from February 2010 to November 2013 were retrospectively analyzed. The patients were divided two groups： a control group（n = 27） and a treatment group（n = 27）. The control group was treated by implantation of simple metal stents, while the treatment group was treated by implantation of self-expandable metal stents withargon plasma coagulation.RESULTS： Self-expandable metal stent placement was successful in all patients. Fifty-four patients were able to take liquid food and soft food within 24 h after the procedure. Pain developed in 4 cases in the control group, and 2 cases in the treatment group. Three cases in the control group developed restenosis 2 mo after surgery, while only one case in the treatment group had restenosis 4.3 mo after surgery. No bleeding or perforation occurred. Two cases in the control group died after 6 mo. The treatment group was superior to the control group in terms of symptoms, food intake, survival and quality of life.CONCLUSION： Placement of a self-expandable metal stent combined with argon plasma coagulation in patients with malignant gastric outlet obstruction is safe and effective for resolving obstruction symptoms.

关 键 词：内镜 恶性胃出口梗阻 金属支架 氩气刀消瘤术 

分 类 号：R735.2[医药卫生—肿瘤]