【作者】 王庆良； 见文成； 谢富波； 张凯； 李春海；

【Author】 Wang Qing-liang1,Jian Wencheng,Xie Fubo et al.Department of radiology,Qilu hospital affiliated to Shandong University,250012,China

【机构】 山东大学齐鲁医院放射科；

【摘要】 目的:回顾性分析食管支架放置对恶性食管疾病的治疗并由此带来的生存质量的提高、生存期的延长以及食管支架放置过程中、术后出现的并发症及其相关因素。方法:利多卡因行口腔及咽喉部麻醉,置开口器,透视下将超滑导丝与8 F大腔导管送入食管内,撤出导丝,经导管行食管造影标记定位病变区。导丝及导管进入胃内,置换不折钢丝,部分病人行预扩张选择合适支架,沿钢丝送至病变部位,透视监视下缓慢释放。结果:本组3 26例食管疾病患者共放置369枚食管支架,34 3枚支架一次放置成功,所有支架释放后即刻位置满意者3 3 7枚。放置支架后患者的一般状况很快得到好转。并发症有疼痛、再狭窄、支架移位、胃内容物反流、出血、支架嵌顿填塞、打嗝,其中1例于放置支架后3 0小时因大出血死亡。结论:对于重度吞咽困难而又失去手术机会或拒绝接受手术治疗的食管癌患者,经口腔放置食管支架是一种操作安全可靠、微创、简单易行、见效快、费用相对低廉的治疗方法。更多还原

【Abstract】 Objective:To evaluate the clinical efficacy and complications of the covered esophageal stents in the treatment of malignant esophageal stricture.Materials:Under fluoroscopic guidance,369 stents were placed in 326 patients.The main symptoms included progressive dysphagia or aphagia,chest pain,choking, emaciation and bleeding.In our study,two kinds of stents were used:one was nitinol stent(NTS),the other was stainless steel"Z"stent(SSZS).Methods of stent placement:An aerosol spray for topical anesthesia (spray and gel lidocaine) was applied to the mouth and pharynx,an 8F big lumen catheter with a super smooth guidewire was passed into the esophagus perorally.Withdrew the guidewire and injected some water-soluble contrast while pulling the catheter upward to show the range of the lesion to verify the diagnosis made previously.Then the location of the lesion in the esophagus was marked.Exchanged the super stiff guidewire.Some patients was dilated.Asuitable stent was displaced under fluoroscopic guidance carefully..Results:369 stents were placed in 326patients.343 stents(92.9%) were placed one time.It was satisfactory of immediate location in 337 stents(91.3%)..Patients condition improved in a short time.In our group,complications included chest pain,restenosis,stent migration,esophagus reflux,bleeding,one patient died of massive bleeding,stent blockage and eructation..Conclusion:Esophageal stent placement was a safe,simple and relatively cheap and dependable management with microtrauma for those who had lost the chance of surgical resection or refused to undergo operation.更多还原