金属内支架治疗胃十二指肠恶性梗阻的临床体会

目的探讨金属内支架治疗胃十二指肠恶性梗阻的技术要点。方法65例胃十二指肠恶性梗阻患者，胃窦癌32例，胰头癌20例，胆管癌8例，十二指肠肿瘤5例；术前胃肠减压；X线透视下置入66枚十二指肠支架，1枚韩新魏支架；术后空肠营养管鼻饲。结果经胃肠减压后63例一次性手术成功置入支架，成功率为96．9％。术后梗阻症状缓解，经空肠营养管鼻饲3～5天后，胃蠕动均恢复，经口饮食。结论术前胃肠减压，使膨胀的胃腔缩小，利于操作，并有利于术后胃蠕动的恢复；置入空肠营养管可使患者较早得到肠内营养，较早缓解症状。

Clinical Experienece of Treating Malignant Gastroduodenal Obstruction by Steel Bracket

Objective To study the technical essential in treating malignant gastroduodenal obstruction by steel bracket. Methods Total 5 patients with malignant gastroduodenal obstruction, gastric antrum cancer is 32 cases, the head of pancreas cancer is 20 cases, cholangiocarcinoma is 8 cases,duodenal tumor is 5 cases;Preoperative gastrointestinal decompression;Placing 66 duodenal steel bracket and 1 hanxingwei bracket in x - ray ; nasal feed by Jejunal nutrition postoperatively. Results The success ratio of 63 cases of placing bracket in the patients＇intestines by operation after conducting gastrointestinal decompression reached as high as 96.9% at the first try. The obstruction symptom remit after the operation. After 3 -5 days＇ of nasal feeding by nutrient canal into the patients＇ empty intes- tines,they restored their gastrointestinal motility and oral in - take ability. Conclusion Decompressing the stomach and intestine before doing operation can deflate the inflated gastral cavity, which is beneficial for conducting of the operation and restoration of gastrointestinal motility after operation. Feeding nutrient canal into a patient＇s empty intestine allows the patient to get nutrition from the intestine early, which is helpful to alleviate the symptom early.