内镜直视与X线机荧屏监测下放置支架术对晚期食管贲门癌患者可行性及安全性分析

【摘要】 目的 探讨内镜直视与X线机荧屏监测下放置支架术治疗晚期食管贲门癌患者的可行性及安全性。方法 选取2012年4月至2017年10月行放置支架术治疗的80例晚期食管贲门癌患者,按照随机数字分组原则将其分为治疗组与对照组,每组各40例。治疗组给予内镜直视下放置支架术治疗,对照组给予X线机荧屏监测下放置支架术治疗,观察并比较两组临床疗效以及术后并发症发生情况。结果 两组患者均为一次性置入支架,其中治疗组置入带膜支架29例次,置入不带膜支架11例次,对照组置入带膜支架32例次,置入不带膜支架8例次,两组患者置入支架成功率均为100%,且支架置入位置准确,膨胀良好,9例食管支气管瘘患者瘘口严密封堵。治疗2周后,治疗组总有效率为90.00%,高于对照组总有效率85.00%,差异无统计学意义(P>0.05)。与治疗前比较,治疗后2周两组患者Stooler分级均明显改善,两组比较差异无统计学意义(P>0.05)。两组患者术后并发症主要有胸痛、出血、支架移位、脱落、穿孔、再狭窄等,两组患者术后胸痛、出血发生率均为100%,且经抑酸、止血处理后均在1周左右缓解。两组术后并发症发生率比较,差异无统计学意义(P>0.05)。结论 内镜直视与X线机荧屏监测下放置支架术治疗晚期食管贲门癌患者均有效,内镜直视下操作简单,放置准确,患者狭窄程度较大可考虑X线机荧屏监测下操作。更多还原

【Abstract】 Objective To investigate the feasibility and safety analysis of endoscopic and X-ray placement of stenting for advanced esophageal and cardiac cancer.Methods 80 patients with advanced esophageal and cardiac cancer who were admitted to our hospital from April 2012 to October 2017 were enrolled in this study.According to the principle of random number grouping,they were divided into two groups:treatment group and control group,40 cases in each group.The treatment group was treated with endoscopic placement under stenting,and the control group was treated with X-ray stenting.The clinical efficacy and postoperative complications were observed and compared.Results The two groups of patients were treated with one-time placement of stents,and 29 cases were treated with stent-graft in the treatment group,11 cases without stent-graft,32 cases with stentgraft in the control group,8 cases without stent-graft.The success rate of stenting in both groups was 100%,and the stent placement was accurate and well-swollen.The fistula of 9 patients with esophageal bronchial fistula was blocked tightly.After 2 weeks of treatment,the total effective rate in the treatment group was 90.00%,which was higher than that in the control group(85.00%),with no significant difference(P>0.05).Compared with those before treatment,Stooler grade of two groups were significantly improved 2 weeks after treatment,there was no significant difference between the two groups(P>0.05).The postoperative complications of the two groups were mainly chest pain,bleeding,stent displacement,shedding,perforation,restenosis,etc.The incidence of postoperative chest pain and bleeding were 100% in both groups,and after acid suppression and hemostasis relieved in about 1 week.There was no significant difference in the incidence of postoperative complications between the two groups(P>0.05).Conclusion Endoscopic and X-ray stenting under the stent in the treatment of advanced esophageal and cardiac cancer patients are effective,endoscopic direct vision is simple,accurate placement,patients with larger stenosis may consider X-ray operation.更多还原