DSA引导下经皮胃造瘘术治疗食管癌伴吞咽困难  

DSA-guided percutaneous radiologic gastrostomy for treatment of esophageal cancer with dysphagia

作　　者：王谭 文秋月 胡鸿涛 黎海亮 WANG Tan;WEN Qiuyue;HU Hongtao;LI Hailiang(Department of Interventional Radiology,Affiliated Cancer Hospital of Zhengzhou University,Henan Cancer Hospital,Zhengzhou 450008,China)

机构地区：[1]郑州大学附属肿瘤医院河南省肿瘤医院放射介入科

出　　处：《中国介入影像与治疗学》2020年第1期13-17,共5页Chinese Journal of Interventional Imaging and Therapy

基　　金：河南省科技攻关计划省部共建项目(201701031)

摘　　要：目的观察DSA引导下经皮胃造瘘术(PRG)治疗食管癌伴吞咽困难的效果。方法回顾性分析194例食管癌伴吞咽困难患者,按照是否接受PRG治疗分为PRG组(DSA引导下PRG后行肠内营养,n=80)和非PRG组(置入食管支架后经口饮食,n=114),比较2组患者术前及术后1个月时体质量指数(BMI)及血清白蛋白、前白蛋白、血红蛋白水平和并发症发生率。结果2组患者术前BMI及血清白蛋白、前白蛋白、血红蛋白水平差异均无统计学意义(P均>0.05),术后2组血清白蛋白、前白蛋白、血红蛋白水平均低于术前(P均<0.05)。术后1个月PRG组血清白蛋白、前白蛋白及血红蛋白水平均高于非PRG组(P均<0.05)。随访期内,PRG组吸入性肺炎、食管-气管瘘发生率低于非PRG组(P均<0.05)。结论DSA引导下PRG能够显著改善食管癌伴吞咽困难患者营养状态,减少吸入性肺炎、食管-气管瘘发生。Objective To explore the therapeutic effect of DSA-guided percutaneous radiological gastrostomy(PRG)in patients with esophageal cancer with dysphagia.Methods Data of 194 patients with esophageal cancer with dysphagia were retrospectively analyzed.The patients were divided into PRG group(enteral nutrition support via DSA-guided PRG,n=80)and non-PRG group(nutritional support through oral feeding after esophageal stent insertion,n=114).Body mass index(BMI),the serum levels of albumin,prealbumin,hemoglobin before and 1 month after operation,and the incidence of adverse reactions were compared between 2 groups.Results There was no significant difference of BMI,albumin,prealbumin nor hemoglobin between 2 groups preoperation(all P>0.05).Albumin,prealbumin and hemoglobin 1 month after operation were lower than those preoperation in both groups(all P<0.05),but in PRG group were significantly higher than those in non-PRG group(all P<0.05).During the follow-up period,the incidences of aspiration pneumonia and tracheoesophageal fistula in PRG group were significantly lower than in non-PRG group(both P<0.05).Conclusion DSA-guided PRG can improve nutritional status and reduce the incidences of aspiration pneumonia and tracheoesophageal fistula in patients with esophageal cancer with dysphagia.

关 键 词：食管肿瘤 食管-气管瘘 肠道营养 血管造影术 数字减影 

分 类 号：R735.1[医药卫生—肿瘤] R814.3[医药卫生—临床医学]