经肠镜联合X线监视金属支架置入治疗左半结直肠癌伴梗阻  

Metal stent placement via colonoscopy combined with X-ray for treatment of left-sided colorectal obstruction

作　　者：朱小三 曾伟 戴益琛 ZHU Xiao-san;ZENG Wei;DAI Yi-chen(Department of Gastroenterology,Chenggong Hospital affiliated to Xiamen University,174^th Hospital of the PLA,Xiamen,Fujian 361003,China)

机构地区：[1]厦门大学附属成功医院中国人民解放军第一七四医院消化内科,福建厦门361003

出　　处：《中国临床研究》2018年第11期1556-1559,共4页Chinese Journal of Clinical Research

基　　金：军区医学科技创新课题项目(15MS099)

摘　　要：目的探讨经电子肠镜联合X线监视金属支架置入治疗左半结直肠癌伴梗阻的临床疗效及操作技巧。方法2014年5月至2017年12月经电子肠镜于X线下金属支架置入治疗的左半结直肠癌伴癌性梗阻患者28例,其中梗阻发生在直肠5例,14例梗阻位于乙状结肠,降结肠梗阻9例。记录支架置入成功率、梗阻缓解及并发症发生情况。结果 25例金属支架放置成功,成功率为89. 3%。梗阻缓解情况:19例患者支架置入后当天症状缓解,5例支架置入后2～3 d梗阻症状得到缓解或消除,1例支架置入术后症状无改善。25例支架置入成功者中,11例支架置入梗阻缓解后7～10 d行外科手术治疗,术后无吻合口瘘及腹腔感染发生;14例支架置入成功患者失去手术机会或心肺脑功能较差而未行手术治疗。并发症情况:全部患者金属支架置入术后未出现大出血或穿孔并发症,1例金属支架经肛门滑脱。结论经电子肠镜联合X线监视金属支架置入治疗可有效缓解左半结直肠癌伴癌性梗阻患者症状,具有操作简单、易被患者接受等优点,可提高患者的生活质量。Objective To investigate the clinical effect and operative skills of metal stent placement via colonoscopy combined with X-ray for the treatment of left-sided colorectal combined with obstruction. Methods Twenty-eight patients with left-sided colorectal cancer with cancerous obstruction located in rectum（n = 5）,sigmoid colon（n = 14） and descending colon（n = 9） were selected. All patients received metal stent placement treatment. The stent placement success rate and the condition of obstructive remission and complications were recorded. Results The metal stent was successfully implanted in 25 cases with a success rate of 89. 3% in whom symptoms of 19 cases were relieved on the day after stent placement,obstruction symptoms of 5 cases were relieved or eliminated 2 to 3 days after metal stent placement,symptoms of1 case were not improved. Out of 25 patients implanted metal stent successfully,11 received surgery treatment 7 to 10 days after obstruction remission caused by metal stent placement in whom no anastomotic leakage and abdominal infection occurred after operation,14 lost surgical chance or did not perform surgery treatment due to poor cardio-pulmonary functions. None of the patients had massive bleeding or perforation complications after metal stent placement. The metal stent slipping through anus was found in one case. Conclusion Metal stent placement via colonoscopy combined with Xray can effectively relieve symptoms of patients with left-sided colorectal cancer with cancerous obstruction and has the advantages of easy to operate,easy to be accepted to patients and can improve patients＇ life quality.

关 键 词：左半结直肠癌 肠梗阻 金属支架 肠镜 X线 

分 类 号：R574.62[医药卫生—消化系统]