胃十二指肠恶性梗阻金属内支架治疗的方法探讨

目的 探讨金属内支架治疗不能手术的胃十二指肠恶性梗阻的方法和疗效.方法 回顾分析9例胰头癌和6例胃癌所致胃十二指肠梗阻患者行金属内支架置入术的资料,分析内支架置人治疗中的操作要点以及影响术后疗效的因素.结果 ①患者术中体位因人而异,因时而异;②经导管注入空气撑开胃腔有利于插管操作;③采用7F指引导管可减少与超硬导丝之间的相对摩擦力;④医生通常在全视野近距离透视下操作,所受辐射剂量较大;⑤插入超长超硬导丝过程中,根据张力将导管导丝联合后撤可减少导丝盘曲;⑥调整超长超硬导丝走向与胃腔形态相符合有利于插入释放器;⑦影响术后疗效的主要因素为病变位置特点、患者饮食习惯及疾病发展转归,患者的死亡原因主要为转移和全身衰竭.结论 关注手术操作的细节和要点是成功实施金属内支架治疗胃十二指肠恶性梗阻的关键,肿瘤的发展转归是影响疗效的决定因素.

The Technique of Metallic Self-expanding Stents in Treating Malignant Gastroduodenal Obstruction

Objective To explore the methods and curative effect of metallic self-expanding stent in inoperable malignant gas-troduodenal obstruction. Methods The data of 15 cases with gastroduodenal obstruction including 9 cases of carcinoma of head of pancreas and 6 cases of carcinoma of stomach were analyzed retrospectively. The operative procedures of the stent implanted and the tors accepted more radiation dose because the manipulation was under the fluoroscopy in a short distance and with a full field of view. sions, the postoperative eating habit and the development turnover of disease. The main death reasons were tumor transfer and sys-tem exhaustion. Conclusion To pay close attention to the details and main points of operative procedure is the key point to implant stent successfully for malignant gastroduodenal obstruction. The determinative factor to influence the curative effect is the develop-ment turnover of tumor.