内镜下金属带膜支架置入治疗食管气管瘘

目的观察与评价国产金属带膜支架置入术作为食管气管瘘(ERF)姑息治疗的价值与临床经验教训。方法22例ERF患者,术前伴明显的肺部感染和严重营养不良及进食呛咳等症状,在内镜直视下置入国产金属带膜支架,观察支架置入成功率、操作相关并发症、支架疗效和并发症等指标。结果①22例患者支架置入术操作一次成功率为82%(18/22),总成功率100%。②支架置入术后患者进食困难均有改善,肺部感染得到明显控制,随访平均生存时间32周(2~96周)。③支架置入术的并发症常见为胸痛、胸闷、出血,对症治疗均能有效控制。结论内镜直视下金属带膜支架置入术对ERF患者是非常有效安全的治疗手段之一,能改善症状,提高患者的生存质量,延长生存时间。

TREATMENT OF ESOPHAGORESPIRATORY FISTULA USING COATED METALLIC STENT BY ENDOSCOPY

Objective To observe and evaluate the clinical value and experience of treating esophagorespiratory fistula using coated metallic stent by endoscopy.Method 22 patients were associated with pulmonary infection,dystrophia and choke.The stent was introduced by direct observation of endoscopy.The success rate,complication rate and curative effect were also observed.Results ①The first success rate of the group was 82%,and the total success rate was 100%.②All patients could take food after the operation,and the pulmonary infection was also controlled apparently.The median survive time was 32 weeks.③The familiar complications such as chest pain,chest tightness and hemorrhage were controlled effectively.Conclusion Coated metallic stent by endoscopy can be used in the treatment of esophagorespiratory fistula as a safe and effective method which improves the patients′life quality and clinical symptoms.