食管覆膜内支架置入治疗自发性食管破裂的疗效观察  

Esophageal covered stent implantation for the treatment of spontaneous esophageal rupture:observation of its curative effect

作　　者：齐县伟 束颖 李志伟[3] 张宪亮[1] 崔天蕾 QI Xianwei;SHU Yin;LI Zhiwei;ZHANG Xianliang;CUI Tianlei(Department of Interventional Radiology,Zhoukou Municipal Central Hospital,Zhoukou,Henan Province 466000,China)

机构地区：[1]周口市中心医院介入科,河南460000 [2]周口市中心医院急诊科,河南460000 [3]周口市中心医院胸外科,河南460000

出　　处：《介入放射学杂志》2020年第9期926-929,共4页Journal of Interventional Radiology

摘　　要：目的总结食管覆膜内支架置入治疗自发性食管破裂的临床经验。方法局部黏膜麻醉、透视下置入经鼻胸腔引流管、食管覆膜内支架与空肠营养管治疗自发性食管破裂24例。术后脓腔灌洗、营养支持、抗炎治疗、对症处理。待脓腔愈合后拔出经鼻脓腔引流管、空肠营养管和食管内支架。结果24例患者成功置入24枚食管覆膜内支架。22例患者食管内支架平均94.3 d顺利取出,取支架过程中未出现大出血、食管破裂等并发症。1例82岁高龄患者术后2个月死于心功能不全。1例患者术后40 d因突然大量呕血、便血而死亡。结论介入治疗自发性食管破裂操作简单、创伤小、疗效确切,是一种值得推广的介入新技术。Objective To summarize the clinical experience of esophageal stent implantation in the treatment of spontaneous esophageal rupture.Methods A total of 24 patients with spontaneous esophageal rupture were enrolled in this study.Under local mucosal anaesthesia and guided by fluoroscopy,the implantation of transnasal thoracic drainage tube,temporary esophageal covered stent and jejunal nutrition tube was carried out in all patients.Postoperative purulent cavity irrigation,nutritional support,antiinflammatory therapy and symptomatic treatment were adopted.The transnasal thoracic drainage tube,jejunal nutrition tube and esophageal covered stent were retrieved when the pus cavity healed.Results A total of 24 esophageal covered stents were successfully implanted in 24 patients with spontaneous esophageal rupture.The esophageal stent was successfully removed in 22 patients in an average time of 94.3 days,and no complications such as massive hemorrhage or esophageal rupture occurred during the process of removing the stents.An 82 year old patient died of cardiac insufficiency 2 months after operation.Another patient died of massive hematemes is and hematochezia 40 days after operation.Conclusion For the treatment of spontaneous esophageal rupture,interventional therapy is technically simple and less traumatic with reliable effect.Therefore,this new interventional technique is worthy of promotion.

关 键 词：自发性食管破裂 内支架 引流 介入放射学 

分 类 号：R655.4[医药卫生—外科学]