儿童可取出式覆膜食管支架置入术后常见并发症的预防及处理  

Prevention and treatment of common complications after esophageal retrievable covered stent placement in children

作　　者：罗刚[1] 刘新献[1] 黄穗[1] 马琦[1] 刘帆[1] 

机构地区：[1]武汉市妇女儿童医疗保健中心影像中心,湖北武汉430016

出　　处：《实用放射学杂志》2015年第6期1002-1005,共4页Journal of Practical Radiology

摘　　要：目的：探讨可取出式覆膜支架治疗儿童良性食管狭窄常见并发症的发生因素、预防与处理。方法15例经食管造影确诊的食管狭窄患儿在透视下行支架置入术,并于2~3周将支架取出,术后追踪观察常见并发症的发生。结果全部病例均一次性成功置入支架,患儿的饮食有明显的改善,从流质—半流质—普食逐渐过渡,狭窄段从0.1~0.6 cm 逐渐扩展为0.6~1.5 cm。术后随访1、2、3周,3月,总结并发症主要为支架脱落、移位5例；食管再狭窄2例；食管-气管瘘1例；术后胸骨后钝痛及异物感6例,根据不同的并发症采取不同的预防与处理。结论儿童覆膜食管支架置入术后并发症较成人多,不容忽视,应行积极的预防和处理。Objective To explore risk factors,prevention and treatment of common complications of benign esophageal stenosis treated with the retrievable covered stents in children.Methods Fifteen cases,diagnosed as benign esophageal stenosis by barium esophagogram were treated with retrievable covered stents under fluoroscopy,Then the stents were removed after 2-3 weeks.The cases were followed-up and complications were observed.Results The stents were successful implanted in all cases.The diet was improved obviously after operation,and gradually transformed from liquid,semiliquid to normal feeding.At the same time,narrow section gradually expanded from 0.1-0.6 cm to 0.6-1.5 cm.Postoperative follow-up was in 1,2,3 weeks and 3 months.Main complications were stents shift in 5 cases,esophageal restenosis in 2 cases,esophageal-tracheal fistula in 1 case,postoperative dull pain behind sternum and foreign body sensation in 6 cases.Relevant preventions and treatments were performed based on different complications.Conclusion It should not be ignored that complications after covered stent placement are more in children than in adults,preventions and treatments should be taken positively.

关 键 词：覆膜食管支架 良性食管狭窄 儿童 并发症 预防及处理 

分 类 号：R571.1[医药卫生—消化系统] R816.92[医药卫生—内科学]