【作者】 胡鸿涛； 黎海亮； 郭晨阳； 杨建伟； 郭旻； 程洪涛；

【Author】 HENAN Tumor Hospital Radiology Department

【机构】 河南省肿瘤医院放射科；

【摘要】 目的：探讨食管内支架置入术前胸部螺旋 CT 扫描的临床价值。方法：对37例食管鳞癌并食管狭窄或食管瘘患者进行食管自膨式覆膜支架置入术前先行胸部螺旋 CT 扫描。在食管内支架治疗全过程中的诊疗行为按规范程序进行。结果：本组37例共置入40枚支架。3例经胸部螺旋 CT 扫描诊断为气管狭窄,行食管、气管双支架置入；5例经胸部螺旋 CT 扫描诊断为纵隔脓肿,经局部+全身抗感染治疗后置入食管内支架。支架置入术的技术成功率为100%。患者吞咽困难改善的程度均在1级以上, 改善率为100%。随访：术后生存时间4～29个月,平均14个月；无1例发生因食管内支架治疗引起的严重并发症：6例患者至今仍存活：31例死亡原因：多脏器转移15例,肿瘤复发8例,肺部感染4 例,大出血3例,其他原因1例。结论：在食管内支架置入术前,胸部螺旋 CT 扫描对于评价患者局部情况有着重要作用,可降低术中呼吸衰竭、大出血的发生率,有利于临床更有效地控制感染,从而进一步提高了食管内支架治疗的安全性,延长了患者的生存期,提高了患者的生存质量,应成为术前必要的、甚至常规的检查项目。更多还原

【Abstract】 Objective To explore the clinic value of bosom SCT scan before the intraesophageal stent implantation.Methods Bosom SCT scan before the intraesophageal stent implantation of 37 cases carcinoma of esophagus with esophageal fistula or esophageal stricture.Diagnosis and treat was according to the standardization process in the stent implantation.Results 37 patients was implanted 40 stents.3 patients was diagnosed tracheal stricture by bosom SCT scan and intubate esophageal stent and tracheal stent coinstantaneous.5 patients was diagnosed mediastinal abscess by bosom SCT scan and intubate esophageal stent after partial and systemic anti-infection treatment.Stents were placed all succeed in one time.The degree of dysphagia was reduced over 1 degree and all patient’s dysphagia was improved.Patients were followed up 4～29 months(means 14 months).Conclusion Bosom SCT scan have an important effect in estimating Patient’s partial status before the esophageal stent implantation,it can debase the chance of respiratory failure and haemorrhage.Bosom SCT scan can enhance the security of esophageal stent treatment,protract patient’s survival time and enhance patient’s survival quality.So bosom SCT scans before the esophageal stent implantation should become a routine and necessary examination.更多还原