不同治疗方案对食管瘘患者预后及生存的影响研究  

Effect of Different Treatment Options on Prognosis and Survival of Esophageal Fistula

作　　者：黄晓光 黄奕芳 林灿峰 陈楚云[1] 林连兴[1] HUANG Xiao-guang;HUANG Yi-fang;LIN Can-feng;CHEN Chu-yun;LIN Lian-xing(Department of Radiation Oncology,Shantou Hospital Affiliated to Sun Yat-Sen University(Shantou Central Hospital),Shantou,Guangdong Province,515041 China;Abdominal Surgery,Affiliated Tumor Hospital,Shantou University Medical College,Shantou,Guangdong Province,515031 China)

机构地区：[1]中山大学附属汕头医院(汕头市中心医院肿瘤)放疗科,广东汕头515041 [2]汕头大学医学院附属肿瘤医院腹部外科,广东汕头515031

出　　处：《中外医疗》2020年第8期40-42,共3页China & Foreign Medical Treatment

摘　　要：目的探讨不同治疗方案对食管瘘患者生存及预后的影响研究。方法方便选取2014年3月-2018年12月该院收治的53例食管瘘患者为观察对象,根据不同治疗方法分为3组。A组28例,行数字减影血管造影(DSA)下覆膜支架置入术,B组22例,行胃镜引导下鼻饲管置入术,C组3例,行肠外营养支持治疗,对比观察3组患者近期生存及预后情况。结果 A组总有效率为89.29%、B组为95.45%,C组为33.33%,A、B组总有效率显著高于C组(χ~2=12.141,P=0.016),A组与B组总有效率对比,差异无统计学意义(χ~2=0.637,P=0.425);A组、B组、C组中位生存期对比,差异无统计学意义(F=0.225,P=0.121)。结论临床治疗食管瘘方法较多,不同治疗方法疗效不一,DSA下覆膜支架置入与胃镜引导下鼻饲管置入可取得较理想近期疗效,但无论采取何种治疗方案,生存期无延长。Objective To explore the effects of different treatment options on the survival and prognosis of patients with esophageal fistula. Methods 53 e patients with esophageal fistula treated in the department from March 2014 to December2018 were convenient selected as observation objects and divided into 3 groups according to different treatment methods. In group A, 28 patients underwent digital subtraction angiography(DSA) stent grafting, in group B, 22 patients underwent gastroscopy-guided nasal feeding tube implantation, and in group C, 3 patients underwent parenteral nutrition support treatment. Observe the recent survival and prognosis of the three groups of patients. Results The total effective rate of group A was 89.29%, group B was 95.45%, and group C was 33.33%. The total effective rate of group A and B was significantly higher than that of group C(χ~2=12.141, P =0.016). There was no statistically significant difference in the comparison of effective rates(χ~2= 0.637, P=0.425);there was no statistically significant difference in the median survival of group A, B,and C(F =0.225, P =0.121). Conclusion There are many clinical methods for treating esophageal fistula, and different treatment methods have different effects. DSA stent graft placement and gastroscope-guided nasal feeding tube placement can achieve ideal short-term effects, but no longer prolonged survival regardless of the treatment plan.

关 键 词：DSA 覆膜支架置入 胃镜引导 鼻饲管置入 肠外营养支持 食管瘘 

分 类 号：R735.1[医药卫生—肿瘤]