内镜下放置食管镍钛记忆金属带膜支架姑息治疗晚期食管癌吞咽困难  

Efficacy of endoscopic placement of esophageal nickel-titanium memory metal band stent for palliative treatment on advanced esophageal cancer with dysphagia and its effects on complications and survival time of patients

作　　者：董翼 徐辉 杨明 乔丽娟 姚群 DONG Yi;XU Hui;YANG Ming;QIAO Lijuan;YAO Qun(Digestive Endoscopy Center,Western Theater General Hospital,Chengdu 610083,China)

机构地区：[1]西部战区总医院消化内镜中心,四川成都610083

出　　处：《西部医学》2020年第9期1354-1357,1362,共5页Medical Journal of West China

基　　金：四川省卫生厅科研课题(100PJ183)。

摘　　要：目的探讨内镜下放置食管镍钛记忆金属带膜支架姑息治疗晚期食管癌吞咽困难患者的疗效及对其并发症和生存期的影响。方法回顾性分析我院2017年6月~2019年6月收治的85例晚期食管癌患者临床资料,患者均接受放化疗,38例患者置入扩张探条纳入对照组,47例患者内镜下放置食管镍钛记忆金属带膜支架治疗纳入观察组,比较两组患者吞咽困难症状缓解情况、并发症、生存期差异。结果观察组患者放疗及化疗完成率均显著高于对照组,差异有统计学意义(P<0.05);置入扩张探条/支架后1个月,观察组患者Stooler吞咽困难分级改善情况优于对照组(P<0.05),观察组和对照组患者并发症发生率差异有统计学意义(P<0.05);观察组和对照组放化疗结束后1个月的生存率(95.74%vs 84.21%)比较差异无统计学意义(P>0.05),化疗结束后6个月的生存率(85.10%vs 65.79%)比较差异有统计学意义(P<0.05)。结论内镜下放置食管镍钛记忆金属带膜支架姑息治疗食管癌吞咽困难疗效确切,有利于患者顺利完成放化疗,且并发症较少,在延长患者生存期方面具有积极作用。Objective To explore the efficacy of endoscopic placement of esophageal nickel-titanium memory metal band stent for palliative treatment on advanced esophageal cancer with dysphagia and its effects on complications and survival time of patients.Methods The clinical data of 85 patients with advanced esophageal cancer in our hospital were analyzed,retrospectively.The patients all received radiotherapy and chemotherapy.38 patients with dilating bougie placement were included in control group,and 47 patients with endoscopic placement of esophageal nickel-titanium memory metal band stent were included in observation group.The differences in relief of dysphagia symptoms,complications and survival time were compared between the two groups.Results The completion rates of radiotherapy and chemotherapy in observation group and control group were 85.11%and 60.53%,and 89.36%and 68.42%(P<0.05).At 1 month after placement of dilating bougie/stent,the improvement of Stooler dysphagia grading in observation group was better than that in control group(P<0.05).The incidence rates of complications in observation group and control group were 21.28%and 42.40%respectively(P<0.05).There was no statistically significant difference in the survival rate between observation group and control group at 1 month after the end of radiotherapy and chemotherapy(95.74%vs 84.21%)(P>0.05),and there was a statistically significant difference in the survival rate between observation group and control group at 6 months after the end of chemotherapy(85.10%vs 65.79%)(P<0.05).Conclusion Endoscopic placement of esophageal nickel-titanium memory metal band stent for palliative treatment has exact efficacy in the treatment of esophageal cancer with dysphagia,and it is conducive to the successful completion of radiotherapy and chemotherapy and has fewer complications and plays a positive role in prolonging the survival time of patients.

关 键 词：镍钛记忆金属带膜支架 姑息治疗 晚期食管癌 吞咽困难 并发症 生存期 

分 类 号：R735.1[医药卫生—肿瘤]