内支架治疗食管恶性狭窄的临床应用研究
食管狭窄,,食管狭窄；介入治疗；内支架,1资料与方法,2结果,3讨论,【参考文献】
【摘要】 目的 采用内支架对食管恶性狭窄患者进行姑息性治疗，评价其临床疗效。方法 本组45例患者，男35例，女10例，年龄49～93岁，平均68岁。其中食管癌34例，贲门部癌11例，病变范围2～15cm，平均7.6cm，食管癌性狭窄伴有食管气管瘘6例。按吞咽困难分级，病变Ⅰ级5例，Ⅱ级29例，Ⅲ级11例。结果 45例患者共置入内支架46枚，(国产支架37枚，Boston Ultraflex 9枚)，1例患者4个月后因支架移位上端再次狭窄，再次叠放支架。所有病例均一次成功。置入后，7～15天梗阻/进食困难症状均明显减轻，6例伴食管气管瘘进食后呛咳立即消失，45例患者未出现食管穿孔、大出血或等严重并发症。生存率，45例恶性患者，6个月73%(33/45)，1年47%(21/45)，2年29%(13/45)，3年20%(9/45)。结论 内支架是治疗食管癌性狭窄有效的姑息性疗法，结合放射治疗和动脉内化疗将明显改善生存质量，提高生存率。【关键词】 食管狭窄；介入治疗；内支架
Clinical application of esophageal stent in the treatment of malignant strictures
ZHU Wen-yu.
Baoshan Branch,The First Peoples Hospital,Shanghai 200940,China
【Abstract】 Objective To study the results and inflancing factors of the treatment of malignant stricture using esophageal stents,and evaluate the value in clinical application.Methods A series of 45 patients,35men,10women,aged from 49～93,with esophageal stricture were enrolled.To place esophageal metallic stent for 45 cases of advanced esophageal cancer.Results 46 stents wewe placed in 45 cases.All stent were successfully placed,only for one with serious complications,including the rupture of esophagus,massive hemorrhage and so on.Conclusion The esophageal stent placement is an safe and effective therapy for malignant esophageal strictures.When combined with radiopraxis and intraarterial chemotherapy,it will improve life quality and raise survival rate. ......
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