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目的评价内支架对上消化道良恶性狭窄及上消化道瘘的治疗价值,总结上消化道内支架的置入操作要点及术后处理经验。材料与方法本组22例,男5例,女7例,年龄45～68岁,平均54岁,食管癌性狭窄11例,食管或胃术后吻合口狭窄8例,食管癌并食管-气管瘘1例,气管插管后气管-食管瘘1例,胃癌术后腹部淋巴结转移幽门狭窄1例。除食管、气管瘘直接安放被膜支架外,单纯狭窄病例均经双腔气囊扩张后经专用输送装置放入裸露式内支架。结果 2例食管瘘支架置入后瘘口封闭,4例食管癌性狭窄置入支架3月内复发狭窄,经内镜下微波烧灼或放疗后梗阻改善,其余均能进普食6个月上,有2例支架滑脱移位。结论食管内支架是解除上消化道狭窄及封闭上消化道瘘的有效而简便的方法,术后处理主要是镇痛及防止支架滑脱,为防止肿瘤生长引起支架阻塞可结合其它治疗。
Objective To evaluate the value of stent in the treatment of benign and malignant upper gastrointestinal stenosis and upper gastrointestinal fistula, and to summarize the operation points and postoperative management experience of stent placement in upper digestive tract. Materials and Methods The group of 22 patients, 5 males and 7 females, aged 45 to 68 years, mean 54 years old, 11 cases of esophageal stenosis, esophageal or gastric anastomotic stenosis in 8 cases, esophageal cancer and esophageal - trachea 1 case of fistula, 1 case of tracheal-esophageal fistula after tracheal intubation, 1 case of pyloric stenosis of abdominal lymph node metastasis after operation of gastric cancer. In addition to esophageal, tracheal fistula stent placed directly outside the stent, the simple cases of stenosis were double-balloon dilatation after special delivery device into the exposed stent. Results Fistula was closed in 2 cases of esophageal fistula stent implantation, 4 cases of esophageal cancer stenosis stent implantation in 3 months recurrence of stenosis, endoscopic microwave ablation or radiotherapy after the obstruction improved, the rest can enter the general diet for 6 months , 2 cases of stent slippage shift. Conclusion Esophageal stent is an effective and simple method to relieve the upper gastrointestinal stenosis and close the upper gastrointestinal fistula. Postoperative management is mainly analgesic and prevent stent slippage. In order to prevent the growth of tumors, the stent can be combined with other treatments.