X线引导下金属支架置入治疗胃十二指肠恶性梗阻32例临床随访研究

目的 探讨X线引导下金属支架置入术治疗胃十二指肠恶性梗阻的临床随访与评价.方法 选取32例胃十二指肠恶性梗阻患者,行X线监视下进入导管导丝,超过狭窄或梗阻段,交换人软头超硬导丝,经超硬导丝置入并释放自膨式金属肠道支架.结果 28例患者成功置入支架,成功率为88％.术中透视造影示支架均定位准确、通畅.27例支架放置后1周内梗阻症状得到缓解或消除,临床有效率为96％.7例术后1个月左右出现梗阻复发,3例予再次放置第2枚支架后缓解.患者术后1个月生存率96％,术后2月生存率61％,术后6个月生存率25％.1例患者目前仍在随访中.结论 X线下金属支架置入治疗胃十二指肠恶性梗阻是一种可行、安全有效的方法.

Follow-up study for 32 cases with malignant obstruction of gastroduodenal treated by implanting stent under X-ray guidance

Objective To make follow-up study and evaluate the clinical value of implanting stent under fluoroscopic guidance for malignant obstruction of gastroduodenal. Methods The catheter and guide-wire were passed through gastro-duodenal stenosis or obstruction, and metallic stents were implanted under the fluoroscopy in 32 cases with malignant obstruction of gastroduodenal. Results The stents were implanted successfully in 28 patients（88%）,all the stents were located precisely under fluoroscopy. The symptoms of obstructive were relieved or disappeared in 27 patients within 1 week and the clinical efficacy was 96%. Recurrent obstruction was observed in 7 eases after one month; of which then the second stent was implanted in 3 cases and the symptoms of obstruction were relieved. Among 28 patients who were treated by implanting stent, the survival rate of one month, two months and six months were 96%, 61%, 25% respectively. One patient was still in the follow-up period （over three years）. Conclusion Implanting stent under fluoroscopic guidance is a convenient, safe and effective method for the palliation of symptoms in patients with malignant obstruction of gastroduodenal.