自膨式金属食管支架安置治疗吞咽困难

目的：探讨自膨式食管支架（Self-Expanding Metal Stent,SEMS)治疗吞咽困难患者临床适应证、疗效及其并发症。方法：收集我院安置的食管支架患者36例临床相关资料。以5分法记录支架安置前后吞咽困难程度。并发症出现的时间以30天为界。结果：吞咽困难评分由安置前的3．4降为安置后的1．1（P＜0．05）。食管－支气管瘘全部痊愈4例。6例患者支架安置后发生了早期并发症：出血2例、胸骨后疼痛不适4例。1例发生了远期并发症：支架移位。结论：自膨式食管支架安置能迅速、有效地改善吞咽困难，提高患者生活质量，延长生存期。是否适用于良性食管梗阻尚有争议。严格掌握适应证及新型食管支架的问世，有望减少安置术后并发症。

Treatment of Patients with Esophageal Dysphagia by Insertion of Self-expandable Metal Stents

Objective:To investigate the clinical indications, efficacy, and complications of self-expandable metal stent(SEMS)insertion for treating patients with esophageal dysphagia.Methods:36 patients with esophageal dysphagia were treated by insertion of SEMS in our department.Their clinical indications, treatment efficacy and complications were analyzed.The degree of dysphagia for each patient was assessed before and after the insertion of SEMS according to a 5-point grading method.The early complications occurred within 30 days after the insertion,and the late complications occurred later than 30 days were recorded and analyzed separately. Results:The mean degree of dysphagia for 36 patients was improved from 3.4 before the insertion to 1.1 after the insertion.Among 36 patients,all 4 patients with fistulas had their fistulas healed up .Early complieations occurred in 6 cases: bleeding 2 cases; pain 4 cases. Late complicalion occurred only in 1 cases, displacement of the stent from its original position. Conclusion:To treat patients with esophageal dysphagia by insertion of SEMS can remarkably improve their degree of dysphagia, their life quality, and can prolong their life expectancy. The application of this treatment method to treat dysphagia caused by benign esophageal stenosis is still in a controvercy at present.Reduction of complications can be achieved if this treatment is adopted under strict clinical indications.