生物降解消化道支架和金属消化道支架的应用价值

背景：消化道内镜下介入治疗是近20年发展起来的微创伤治疗新技术,已成为治疗消化道狭窄或梗阻的首选方法。目的：总结分析生物降解消化道支架和金属消化道支架的应用价值。方法：以“消化道、生物材料、金属支架、复合材料、复合支架”为中文关键词,采用计算机检索中国期刊全文数据库、PubMed数据库1993-01/2010-11相关文章。纳入生物消化道支架-金属消化道支架的应用等相关的文章,排除重复研究或Meta分析类文章。结果与结论：共入选25篇文章进入结果分析。消化道狭窄采用内镜下高频电凝电切,微波、探条扩张等均有一定效果, 但有疗效短需反复治疗的缺点。金属内支架置入具有操作简便,创伤小,并发症少,且相对费用较低的优点。可降解支架可以解决良恶性狭窄的再通及瘘口的封堵等,在消化道疾病中的应用已经显示其有效的扩张性及临床安全性,但其材料的选择、支架的设计及降解时间的调节等都需要通过未来更多的临床应用来评估。

Clinical value of biodegradable and metal gastrointestinal stents

BACKGROUND:In the last 20 year, gastrointestinal endoscopic intervention as a new minimally invasive technique is developed as the preferred method for treatment of gastrointestinal stenosis or obstruction.OBJECTIVE:To summarize the clinical values of biodegradable and metal gastrointestinal stents.METHODS:A computer-based search of CNKI and PubMed was performed for relevant articles published 1993-01/2010-11 using the keywords of “digestive tract, biomaterials, metal stent, composite materials, composite stent”. Repetitive articles or metal-analysis were excluded.RESULTS AND CONCLUSION:Finally, 25 articles were included in result analysis. Endoscopic high-frequency transurethral electrocoagulation, microwave, bougienage have a certain effect on gastrointestinal stenosis, but the effect lasts only for a short time. This treatment need to be repeated. Metal stents are characterized as easy to be implanted, less invasion, few complications and relatively low costs. Biodegradable stents can resolve the problems of recanalization of benign and malignant stenosis and through the malignant stricture and fistula closure, showing an effective expansion and clinical safety in the treatment of digestive diseases. However, material selection, stent design and degradation time regulation require further studies in the clinical application of biodegradable stents.