经鼻胃镜在食管狭窄扩张和支架治疗中的应用

目的探讨经鼻胃镜在食管狭窄扩张和支架置入术中的作用。方法 2007年10月-2009年3月对28例癌性食管狭窄以及并发食管-气管瘘的患者行PENTAX（EG-1580K）超细经鼻电子胃镜检查,计算插入深度,并进行扩张和支架治疗,在胃镜直视下调节输送器内支架上端的位置,观察扩张效果、支架放置成功率、定位的准确性以及并发症情况。结果全部患者均行扩张治疗,效果良好,支架一次性放置全部成功,定位准确,自膨满意,最狭窄处的内径由（4.8±1.2）mm扩至（12.5±1.5）mm,食管气管瘘被覆盖治疗效果好,患者的吞咽困难评级由3.25±0.58降至0.94±0.59。结论在食管狭窄扩张和支架置入术中应用经鼻超细胃镜患者依从性好,方法简便,安全有效。

The Clinical Application of Nasal Endoscopy in patients with Esophageal Stenosis Stent Expansion

Objective To explore the role of nasal endoscopy in the esophagostenosis expansion and esophageal stent.Methods PENTAX（EG-1580K）ultrafine nasal endoscopy was used in 28patients（October 2007-March 2009）with esophageal cancer complicated with esophagostenosis and fistula to check the e-calculated insertion depth,stent expansion and the average diameter expansion.The endoscopy was carried under the direct vision with the location of the top bracket in order to ensure the accurate stent placement,all without X-ray assist.The success rates of stent placement,positioning accuracy,as well as complications were evaluated.Results The expansion treatments were successful in all patients with one-off operation.The narrowest part increased from（4.9±1.6）mm to（12.7± 1.5）mm,and the esophageal fistula was covered.The rating of dysphagia decreased from 3.15±0.68to 0.91± 0.49.Conclusion Nasal endoscopy is simple,safe and effective in the treatment of ultrafine expansion for esophagostenosis and stent implantation with good compliance.