自膨式金属内支架治疗食管狭窄和食管瘘

目的 探讨金属内支架治疗食管狭窄和食管瘘的疗效及临床需要注意的问题.方法 31例患者中食管狭窄30例(其中5例合并食管瘘),自发性食管破裂1例.在X线电视监视下,31例患者共置入33枚食管支架,带膜支架30枚,裸支架3枚.结果 31例患者均一次性置入成功.30例食管狭窄的患者术后吞咽困难症状明显改善,6例有食管瘘的患者瘘口完全封堵,无术中并发症.术后2例出现消化道大出血死亡,5例出现支架一端明显狭窄或支架移位,其中2例通过再置入支架治疗,1例外科手术,2例放弃治疗.23/27例食管恶性病变患者在随访期死亡,平均生存期6.1个月.结论 内支架置入治疗食管狭窄和食管瘘安全、有效、操作简单、并发症少.

Self-expanding Metallic Stents for Treatment of Esophageal Stenosis and Esophageal Fistula

Objective To investigate the effectiveness and the attentiveness in clinical dealings inthe treatment of esophageal stenosis and esophageal fistula with self-expanding metallic stent.Methods Under fluoroscopic guidance,33 stents were implanted in 31 patients,including 25 withesophageal stenosis,5 with esophageal stenosis accompanied by esophageal fistula,one with spontaneousesophageal fistula.Of the 33,30 were coated stents and 3 were uncoated stents.Results Successfulstent placement was achieved in all cases.30 patients with esophageal stenosis had made significantimprovement in dysphasis.Fistulas was completely sealed in 6 patients with esophageal fistula.Thecomplications were not encounted duing the operation.23/27 patients with malignant esophagealstenosis died within the follow-up period,the avevage survival time was 6.1 months.Conclusion stentsplacement is a safe,simple and effective method to treat the esophageal stenosis and esophagealfistula.