一种新型肠道支架治疗远段十二指肠恶性梗阻的应用体会  

A Newly Designed Stent for Management of Malignant Distal Duodenal Obstruction

作　　者：周卫忠[1] 杨正强[1] 刘圣[1] 夏金国[1] 周春高[1] 赵林波[1] 施海彬[1] 

机构地区：[1]南京医科大学第一附属医院介入放射科,南京210029

出　　处：《中国医疗器械信息》2016年第11期17-21,共5页China Medical Device Information

摘　　要：目的:评价一种新型国产支架治疗远段十二指肠恶性梗阻的有效性。方法:该种新型支架为鸟巢式编织型支架,支架的输送系统的内层为金属网格。从2011年3月至2013年5月,6例远段十二指肠恶性梗阻的患者采用了该种新型支架治疗。该6例患者的原发病分别为:3例为胰腺癌,2例为胃癌,1例为子宫内膜间质肉瘤。十二指肠的梗阻部位分别为:2例在十二指肠水平部,2例在十二指肠升部,2例在十二指肠空肠曲。对手术技术成功(定义为支架成功释放)、手术前后的临床症状以及并发症进行了评估。结果:所有患者的手术技术上均取得了成功,未出现严重并发症。治疗前,两例患者不能进食,胃输出道梗阻评分(GOOSS)为0;其余4例只能进食流质,GOOSS评分为1。治疗后,5例患者能进软食(GOOSS评分为2),1例能正常进食(GOSS评分为3)。支架的平均通常时间为115.7天。结论:这种新型国产肠道支架初步临床应用的结果表明其释放技术成功率高,临床效果满意,因此可推广应用于治疗远段十二指肠恶性梗阻。Purpose： To evaluate the clinical effectiveness of a newly designed stent for the treatment of malignant distal duodenal obstruction. Materials and Methods： From March 2011 to May 2013, six patients with malignant duodenal obstruction underwent fluoroscopically guided placement of the new duodenal stent consisting of braided, nested stent wires and a delivery system with a metallic mesh inner layer. Primary diseases were pancreatic cancer in three patients, gastric cancer in two patients, and endometrial stromal sarcoma in one patient. Duodenal obstructions were located in the horizontal part in two patients, the ascending part in two patients, and the duodenojejunal flexure in two patients. Technical success, defined as the successful stent deployment; clinical symptoms before and after the procedure; and complications were evaluated. Results： Technical success was achieved in all patients. No major complications were observed. Before treatment, two patients could not take any food and the gastric outlet obstruction scoring system （GOOSS） score was 0; the other four patients could take only liquids orally （GOOSS score = 1）. After treatment, five patients could take soft food （GOOSS score = 2） and one patient could take a full diet （GOOSS score = 3）. The mean duration of primary stent patency was 115.7 days. Conclusion： The newly designed stent is associated with a high degree of technical success and good clinical outcome and may be clinically effective in the management of malignant distal duodenal obstruction.

关 键 词：远段十二指肠梗阻 编织型支架 透视 

分 类 号：R318[医药卫生—生物医学工程]