食管支架置入术 ——X线下和内镜下两种置入术方法的比较

目的　探讨食管支架对食管狭窄的实用价值，着重比较X线和内镜下两种置入方法的优缺点。方法　40例患者置入41个支架，其中X线法27个，内镜法14个。结果　支架置入顺利，无严重并发症发生。术后患者吞咽困难程度明显改善，由术前平均3.4级降至1.03级。X线法置入的27个支架位置全部准确，而内镜法置入的14个有4个发生位置偏差。结论　食道支架治疗食道狭窄安全有效。两种置入方法各有优缺点，在狭窄段通过方面内镜法有优势，在狭窄段扩张和支架定位方面X线法更安全和准确。

Esophageal Stent Implantation--Comparison between Fluoroscopic and Endoscopic Intubation

Objective To evaluate the clinical value of esophageal stents in esophageal stenosis,emphatically to compare the advantages and disadvantages between fluoroscopic and endoscopic intubation.Methods Forty-one stents were implanted in 40 patients. Of them 27 stents were intubated fluoroscopically guided and 14 endoscopically guided.Results There were no serious stent-related complications in all cases. After the stent implanted, dysphagia were obviously improved and the average degree of dysphagia lowered from grade 3.4 to 1.03. Precise stent intubation was achieved in all the 27 fluoroscopically guided intubation, but positional deviation was discovered in 4 of the 14 endoscopically guided intubation. Conclusion Esophageal stents appear to be safe and effective for esophageal strictures. Fluoroscopic and endoscopic intubation has its own advantages and disadvantages respectively. Endoscopical intubation has superiority in passing through the stricture, but in dilatation of the strictures and precise positioning of the stents, fluoroscopic intubation is safer and more accurate.