胃镜测距盲推置入支架术对高位食管癌的临床疗效观察  

Clinical experience of posting esophageal stent in upper esophageal carcinoma with blind endoscopic ranging

作　　者：邱洪清[1] 何斌[1] 卢亚萍[1] 任丽华[1] 

机构地区：[1]苏州大学附属张家港市第一人民医院消化内科,江苏苏州215006

出　　处：《临床消化病杂志》2015年第4期219-221,共3页Chinese Journal of Clinical Gastroenterology

摘　　要：[目的]观察胃镜测距盲推支架置入术对高位食管癌的临床疗效。[方法]对50例高位食管癌患者采用胃镜测距盲推支架置入术,观察操作成功率、吞咽困难缓解情况、不良反应发生率以及术后生存时间。[结果]50例患者共置入50枚支架,均为一次性置入;支架置入后吞咽困难较治疗前明显缓解（P〈0.05）。术后有恶心呕吐症状8例,异物感、轻度胸部胀痛不适感4例,支架移位3例,食团堵塞支架11例,支架上端再狭窄2例。随访24个月内,35例患者死于肿瘤全身转移或全身器官衰竭,且临终前Stoller分级均为Ⅱ~Ⅲ级,无食管穿孔发生。[结论]胃镜测距盲推置入支架介入治疗高位食管癌较胃镜直视法、X线下法具有明显的优势,可有效缓解吞咽困难,患者痛苦小,且易于操作。[Objective]To explore the clinical effect and experience of blind endoscopic ranging esophageal stent in upper esophageal carcinoma.[Methods]Fifty patients with upper esophageal carcinoma in our hospital were treated by posting esophageal stent via blind endoscopic ranging during 2009.12-2013.12.During the follow-up period,the success rate,dysphagia score,post-operation complications,and patient survival were evaluated.[Results]Fifty stents were successfully placed in the 50 patients.After the operation,dysphagia was significantly relieved（P 〈0.05）.Postoperative nausea and vomiting symptoms presented in 8cases,foreign body sensation,mild chest pain and discomfort presented in 4cases,stent displacement happened in 3cases,stent occlusion presented in 11 cases,tissue of upper stent overgrowth presented in 2cases.During the following 24 months,35 patients died of metastasis or organ failure,and Stoller classed Ⅱ-Ⅲ on the deathbed without esophageal perforation occurred.[Conclusion]Posting esophageal stent in upper esophageal carcinoma with blind endoscopic ranging has greater advantages than under endoscopy or X line method,which can reduce patients＇ dysphagia and pain,and is easy to operate.

关 键 词：高位食管癌 食管支架 临床体会 

分 类 号：R735.1[医药卫生—肿瘤]