金属支架在晚期胃癌消化道梗阻中的应用

目的 探讨金属支架置入治疗晚期胃癌消化道梗阻的方法和临床疗效.方法 46例晚期胃癌消化道梗阻采用X线监视下支架置人及胃镜直视结合X线监视下支架置人法,观察临床效果和并发症.结果 金属支架均能一次性成功置人,成功率100%,上消化道梗阻症状迅速解除,术后3d内恢复了流质至软食的快速过度,1个月后平均体重加5.1kg,中位生存期达到11.5个月.胸腹痛为本组常见术后并发症,大多可耐受,少数经止痛治疗,均能在7d内消失.术后再狭窄经胃镜下治疗,或再放置1枚支架,保持支架再通畅,无1例发生感染、穿孔.结论 金属支架置人治疗晚期胃癌消化道梗阻近期临床疗效显著,是一种安全有效的姑息性治疗方法.

Clinical application on placing metallic stent for advanced gastric cancer with obstruction of digestive tract

Objective To study the therapic ways and clinical efficiency of placing metallic stent for advanced gastric cancer with obstruction of digestive tract.Methods 46 patients of advanced gastric cancer with obstruction of digestive tract were adopted by placement of stent under the X ray guidance or placement of stent under endoscopy by straight sight combined with X ray guidance.Then the clinical efficiency and complications were observed.Results All stents were placed successfully in the first try and successful rate was 100%.The obstructive symptoms of upper digestive tract were relieved immediately.All patients could intake a liquid diet and soft diet in 3 days speedily after the operation.The weight increased average 5.1kg.Mean survival period was 11.5 months.Chestache and stomachache was common complications after the operation,the majority of which could be borne,only the minority of which needed to be treated by analgesic drug ,and those symptoms could disappeared in 7days.Restenosis after the operation was again kept lucid by endoscopic therapy or placing one stent again.No infection and perforation occurred.Conclusion Placing metallic stent for advanced gastric cancer with obstruction of digestive tract was very significant,and it is a safe and efficient palliative therapic method.