食管金属内支架的临床应用(附37例报告)

目的:评价食管金属内支架临床应用效果。对象与方法:37例病人其中12例食管-胃吻合口狭窄,8例食管癌致食管气管瘘,6例食管癌放疗后狭窄,5例食管癌性狭窄,2例食管癌术后吻合口复发,以及4例贲门失弛缓症,在透视下(24例)或纤维内窥镜下(13例)被置放了国产食管金属内支架。结果:置放食管金属内支架后,全部病人食道梗阻症状均较原来有某种程度的缓解,其中,17例能进普食,15例能进半流食,只有5例需用流食。除1例于术后1周死于并发腹腔内感染外,其余36例于术后6至9个月复查表明,30例一直保持良好状况,仅有6例因食管癌进展或术后吻合口复发而致食管再度出现狭窄,然而经气囊导管再次扩张后,狭窄得以迅速缓解。结论:食管-胃吻合口狭窄,食管癌放疗后狭窄,以及贲门失弛缓症是采用食管金属内支架的最佳适应症。

Clinical applications of intra-esophageal metal stent: A preliminary study in 37 patients

Purpose: To assess the clinical therapeutic effects of the metal intra - support for esophageal stenosis induced by different causes. Materials and Methods: Esophageal metal intra - supports produced by China were placed into esophagus of thirty - seven patients who were 12 stenosis of esophagogastro -anastomotic mouth, 8 esophagotrachea leakage from esophagus cancer, 6 post radiotherapeutic stenosis from esophagus cancer, 5 cancerous stenosis of esophagus, 2 recurrences of postoperative anastomotic mouth from esophagus cancer, and 4 cardial relaxation-loss sign under roentgenoscopy (24 patients) and under fi-broendoscopy(13 patients). Results: Following esophageal metal intra - supports to be placed the obstruent symptoms of esophagus in all patients were more or less moderated than that before the operation, of them, 17 patients can took in general foods, 15 patients can took in half liquid foods, while only 5 patients needfully took in liquid foods. Except one patient was dead at postoperative one week due to complicated by infection in abdominal cavity, in other 36 patients the followed up investigations showed that they always kept a well state within 6 to 9 months after the operation but 6 patients of them because of the progress of esophageal cancer or its recurrence of postoperative anastomotic mouth again revealed themself esophagus stenosis, however, when the expansile operations were performed by an air cystic catheter, these stenosed lesions obtained immediately the moderation. Conclusion: Stenosis of esophagogastro anastomotic mouth, post - radiotherapeutic stenosis from esophagus cancer, and cardial relaxation - loss sign are the best indications for adopting esophageal metal intra - support.