【摘要】 目的　置入188Re放射性同位素支架,解除食管梗阻,姑息治疗食管狭窄,提高患者生存质量 方法　对30例食管恶性狭窄病例,随机分为2组,分别置入188Re放射性支架、普通覆膜支架作前瞻性研究 结果　188Re放射性支架初始活度128MBq经3个半衰期2 12d,皮下0 5mm粘膜参考点吸收剂量21 62Gy,皮下4mm肌层参考点吸收剂量4 07Gy 全部病例均一次置入成功,定位准确,支架复张良好 恶性狭窄缓解率93%(14/15,CR4+PR10),中位生存时间14个月,一年生存率66 67% 而对照组中多数病例于置入普通覆膜支架后3～6月因肿瘤向支架上下端生长造成再次狭窄,其中位生存时间9个月,一年生存率33 33%,较放射支架组差异显著(P<0 01) 放射支架组与对照组部分病例置入支架后出现胸骨后疼痛、暂时发热及出血,经治疗后缓解 结论　188Re放射性支架治疗食管恶性狭窄近期疗效好、急性放射反应小,可作为姑息治疗手段更多还原

【Abstract】 OBJECTIVE: Using the Radioactive isotope stent to relieve and treat malignant esophageal obstruction, to improre life quality of the patient. METHOD: Cohort study observed （）¹⁸⁸Re radioactive isotope stent in esophagus to treat 15 cases of esophageal malignant constriction and matched 15 cases controls following up the clinical effects. RESULT: （）¹⁸⁸Re stent given 128 MPq rediation dose for 2.12 days detected the mucosa reference point dose 21.63 Gy and the muscle dose 4.07 Gy. All cases were put in successfully with exact location and good recovery of the stent. The malignant constriction remission rate is 93%（14/15, completely remission CR 4 and part remission PR.10）. After 6～12 months of follow-up the radioactive isotope stent group has no local tumor relapse occurred. In controls the most cases relapse within 3～6 months. The replasing tumor growth from the superior and inferior ends and from membrane toward the lumen. Then it causes second constriction and dysphagia in controls. In majority of cases occurred retrosternal pain and esophageal reflux after putting the stent. The part of the cases occurred temporary febrile after operation and hemorrhage was few. CONCLUSION: It is a safe and valuable method using the （）¹⁸⁸Re stent to treat malignant esophageal constriction.更多还原