影响临时性覆膜支架治疗食道贲门失迟缓症的疗效分析

目的 分析和探讨临时性覆膜支架在治疗贲门失迟缓症时的不良因素和解决的方法 方法 选择39例食道贲门失迟缓症患者,男21例,女18例,共治疗43次.年龄最大64岁,最小15岁,病程最长27年,最短1年.全部病例经食道钡餐检查,狭窄小于5 mm以下,胃镜病理检查良性.支架选用国产覆膜可回收自膨式支架,采用一步法置入.支架置入时间2周或者3周.术后对症处理及口服0.9%NS 250 ml加庆大霉素8万单位,3次/d.连续3 d.结果 全部病例支架置入一次成功,有2例10 d内支架滑入胃内,其中1例取出后重新置入,另一例未再置入;1例12天时取出.取出支架后复查食道钡餐,食道均有不同程度扩张.术后半年内复发8例,其中两例行外科手术治疗,4例再行食道内支架治疗.其余效果较稳定,最长已达79个月未再做治疗.手术时无食管破裂,大出血等严重并发症发生.结论通过对39例经食道内支架治疗患者的分析,食道内支架治疗贲门失迟缓症时,通过对患者饮食习惯的控制、年龄的选择,支架大小的选择,可以提高治疗的有效率,降低病情的复发.

The effect analysis on the temporary stent-grafttreatmentof esophageal achulasia disease

Objective To analyse and explore the adverse factors and solutions on the temporary stent-graft treatment of esophageal achalasia disease. Methods 39 patients with diagnosis of esophageal achalasia disease of were studied. There were male group(21 cases)and female group(18 cases) ,ranging from 15 to 64-years-old. The longest disease course was 27 years and the shortest was only 1 year. They have been treated 43 times. All cases have been esophagealled by barium med examination(narrow less than 5 mm)and Endoscopic biopsy(benign) confirmed. To select China-made recyclable plastic self-expanding stent, to adopt one-step into the esophagus, Stent stay for 2 weeks or 3 weeks. Symptomatic treatment after operation, oral 0.9% NS. 250 ml gentamicin plus 80,000 units,3 times/day and 3 consecutive days. Results All cases of stent placement was successful only once. During the treatment,2 cases stent slided into stomach in 10 days, 1 case of them remove the stent and then placement again, and another case didn't replace. In addition, one case removed the stent in 12th days. To remove the stent and then review esophageal barium med examination ,which have been confirmed the esophagus were expandment in vary degrees. After six months, 8 cases of recurrence, two of which adopted routine surgical treatment ,4 cases of re-line treatment of esophageal stent. The remaining patients effect were sta-ble,reached a maximum of 79 months not to treat again. In the process of implementation during the operation, there have not severe complications such as esophageal rupture ,bleeding. Conclusion To analyse the 39 cases transesophageal treatment of patients with stents, we can seen the esophageal stents in the treatment of esophage-al achalasia disease is safe and effective. Through controlling the eating habits of patients, choosing to the pa-tients and the adjustment to the esophageal stent sizes, we can concluded the treatment can improve the efficien-cy and then reduce recurrence of the disease.