带膜支架在食管狭窄中的临床应用

目的：本文回顾性分析了金属带膜支架对恶性食管狭窄、吻合口狭窄及食管气管瘘和吻合口瘘的治疗功效，方法：36例吞咽困难患者放置了Gianturco-Z和自彭式金属带膜支架。其中包括恶性食管梗阻（32例）、吻合口狭窄（4例），合并食管气管瘘（3例）和吻合口瘘（1例）。结果：37根支架被成功释放。吞咽困难在33例患者中获得明显缓解，平均吞咽困难积分从3．02减低到0．81。3例食管气管瘘和1例吻合口瘘完全堵住。并发症包括胸骨后疼痛（23例）、支架移位（21例）、上消化道出血（12例）、返流性食道炎（1例）和气管受压迫（1例）。结论：金属带膜支架是治疗食道梗阻、食管气管瘘及吻合口瘘安全、有效的方法。

Clinical application of the covered metallic stents in the treatment of esophageal stenosis

Objective:To evaluate the clinical efficacy of the covered metallic stents in the treatment of dysphagia secondary to malignant esophageal obstruction,anastomotic stenoses,esophagorespiratory(ERF) and anastomotic fistula,respectively.Methods:Thirty six patients with dysphagia due to malignant esophageal obstructions (n=32,including ERF n=3),anastomotic stenoses (n=3),and anastomotic fistula(n=1) were treated with polyethylene covered Gianturco Z and silicone covered self expandable stents.Results:Thirty seven stents were placed in 36 patients and stents placement was technically successful in all patients. The dysphagia of 33 patients was dramatically improved poststenting and also the average dysphagia score decreased from 3.02 to 0.81.Three ERF and one anastomotic fistula were completely closed.Complications included chest pain(n=23),stent migration(n=21),upper gastrointestinal tract hemorrhage (n=12), reflux esophagitis (n=1) and tracheobronchial compression (n=1).Conclusion:Implantation of the covered metallic stents is a relatively safe and effective method in palliation and treatment of the patient with esophageal stenosis and esophagorespiratory anastomotic fistula.