【摘要】 目的应用带膜金属支架治疗癌性难治性食管狭窄和瘘,并对近、远期疗效进行观察。方法在电子内镜下应用扩张器和支架置入器,对临床确诊的难治性食管狭窄和(或)瘘的48例患者进行支架置入术。根据病情的不同情况选择不同的治疗方式。结果48例患者共放置支架64个,置管后狭窄处直径由(4.02±1.35)mm增至(15.05±4.02)mm(P<0.01),吞咽困难由3.28±0.42级改善为0.94±0.73级(P<0.01),食管瘘患者瘘口全部闭合。随访1个月及1年有效率分别为100%、74.2%,1年失访共3例,复发共8例经重复治疗缓解。结论内镜直视扩张置管治疗难治性食管狭窄和瘘,操作直观简便,定位准确,成功率较高,近远期效果较好。更多还原

【Abstract】 Objective To evaluate the short-term and long-term efficacy of the coated metallic stent insertion in treating complexity esophageal stricture and(or) fistula caused by carcinoma.Metheds Fourty-eight cases with complexity esophageal stricture and(or) fistula caused by carcinoma had undergone the treatment in our hospital.The patients were evaluated for symptomatic dysphagia improvement 1-month and 12-months after treament.Additionally,various complications related to the treatment had been observed.Results Placement of stents in all cases was succassful.All of them nearly complete symptomatic dysphagia reliered or significanty improved.The diameter of the stricture increased from(4.02±1.35)mm to(15.05±4.02)mm(P<0.01).Dysphagy gradient decreased from 3.28±0.42 to 0.94±0.73(P<0.01).The effective rates for following-up 1 month and 12 months after the therapy were 100%,74.2% respectively.Three cases lost contact and eight cases had dysphagia relapse during the months follow-up.Conclusion Stenting under endoscopy is proved to be a safe and effective method with short-term and long-term efficacy and low complications.更多还原