胃肠道狭窄或梗阻内支架置入术后常见并发症及其处理

目的：探讨肝肠道或梗阻内支架置入术后常见并发症及处理办法。对象与方法：６０例胃肠道狭窄或阻病人，其中食管狭窄或梗阻３９例，胃十二指肠梗阻或狭窄２１例。在Ｘ光线监视下共放置支架６６只，其中带模２７只，不带３９只。结果：６０例病人中，所有支架安放１－３次成功。疼痛１２例，轻微胀痛１０例，中度胀痛１例，重度疼痛，地轻中度胀痛给予止痛片等对症处理：重度疼产能，药物控制无效者，给予硬膜外麻醉止痛。胃财狭窄９

Common Complications and Treatment in Stricture or Obstruction of Gastrointestinal Tract with Stent Insertion

Purpose:To study common complications and method of treatment in stricture or ob- struction of gastrointestinal tract with stent insertion.Materials and Methods:Strictures or obstructions of gastrointestinal tract in 60 patients were inserted with 66 stents under fluoroscopic control.39 of 60 pa- tients had strictures or obstructions of esophagus;21 had strictures or obstructions of gastroduodenum; including 23 coated and 39 uncoated stents.Results:All stents were by one to three times successfully placed in sixty patients.Chest pain occurred in 12 patients(20%)Slight or dull chest pain in 10with one patients treated by analgesic and serious chest pain in one treated by peridural anesthesia.Restenosis of gastrointestinal tract in 9 patients(15%)including tumor overgrowth in 6 and hyperplasia of granulation tissue in 3 which were necessasy for inserting the second stent in 3 patients under fluoroscopic control and cauterized by hot-node therapy in 6 patients under gastroscopicy guidance.Reflux occurred in these 5 patients(8%)after stent placement,reflux esophagitis was managed by common antireflux measures.Stent displacement occurred in 3 patients(5%)and were cured by extraction in 2 with replacement in one patients under gastroscope.Gastrointestinal hemorrhage occurred in 3 patients(5%)and were treated by hemostat.Food-bolus obstruction in 2 patients(3%)were treated by means of endoscopic removal. Couclusion:Common complications in stricture or obstruction of gastrointestinal tract with stent insertion were chest pain and restenosis of gastrointestinal tract,reflux,stent displacement,bleeding and food- bolus obstruction.Complications were treated in combination of stents gastroscopy and drugs.