X线辅助下经结肠镜放置金属支架治疗结直肠癌梗阻的临床应用  

Clinical value of endoscopic metal stenting for colorectal cancer obstruction under X-ray

作　　者：杨大明[1] 徐莹[1] 彭海霞[1] 周锋利[1] 李吉[1] 蒯榕[1] 

机构地区：[1]上海交通大学医学院附属同仁医院内窥镜室,上海200336

出　　处：《外科研究与新技术》2016年第2期82-84,107,共4页Surgical Research and New Technique

摘　　要：目的观察结肠镜下金属支架置入术治疗结直肠癌梗阻的疗效。方法回顾性分析2012年9月—2015年7月,在X线透视下,经结肠镜辅助放置金属支架治疗结直肠癌梗阻的患者27例,男性17例,女性10例,中位年龄66岁。其中乙状结肠癌17例,降结肠癌6例,直肠癌3例,横结肠癌1例。结果 27例患者中,25例放置支架成功,成功率92.6%,术后1 d梗阻症状缓解或消失,无严重并发症。22例金属支架术后5-12 d行Ⅰ期肿瘤切除,还有1例支架术后38 d手术切除,术后均恢复顺利。其余2例支架为姑息治疗。结论在X线透视下,经结肠镜辅助放置金属支架解除结肠梗阻安全有效,迅速减轻患者痛苦,使结肠癌梗阻患者能够得到外科Ⅰ期手术切除吻合。Objective To observe the efficacy of endoscopic metal stenting forcolorectal cancer obstruction under X-ray. Methods The clinical data of 27 patients,17 males and 10 females with the median age of 66,who received X-ray-guided endoscopic metal stenting between September 2012 and July 2015 were retrospectively analyzed. The obstruction sites of these 27 cases were sigmoid colon（n=17）,descending colon（n=6）,rectum（n=3）and transverse colon（n=1）. Results Of the 27 patients,25（92.6%）were successfully inserted with metal stents,and showed relief or disappearance of symptoms 1 d after operation,with no major complications. Among these 25 patients,22 underwent elective surgical resection 5 to 12 d after operation with good recovery,1 did it 38 d after operation with good recovery,and the other 2 received palliative treatment. Conclusion Endoscopic metal stent placement under X-ray can effectively relieve the obstruction symptoms caused by colorectal cancer,which helps patients in surgical resection and anastomosis.

关 键 词：X-线 金属内支架 内镜 结直肠癌 梗阻 

分 类 号：R735.34[医药卫生—肿瘤]