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目的研究食管金属支架治疗食管狭窄的价值。方法22例患者首先通过内镜观察狭窄病变的性质,狭窄上缘距门齿、食管上端开口处的距离,然后准确插入导引钢丝,用沙氏扩张器由细到粗进行扩张至内镜顺利通过,再次内镜检查通过狭窄段观察狭窄的长度、病变的性质,确定所放支架的长度、直径和支架的位置,最后将附有金属支架的推进器沿导丝插入狭窄部,确定支架位置准确后缓慢释放支架,所有过程均在内镜直视下单独完成操作。结果22例患者21例一次放置成功,1例第二次放置成功,患者吞咽困难症状明显改善,术后2 h进流质,2~4 d后进普食,侧位胸片和内镜双重检查,支架位置准确,形状为两头呈喇叭样,中间狭窄部直径1.2~1.5 cm。所有患者均未出现严重不良反应。结论内镜直视下置入食管支架治疗食管狭窄是一种简单且安全、有效的姑息性方法,可极大改善病人的生活质量。
Objective To study the value of esophageal metal stent in the treatment of esophageal stenosis. Methods Twenty-two patients underwent endoscopic observation of the nature of the stenotic lesion. The upper margin of the stenosis was at a distance from the incisors and esophagus at the upper opening. Then the guide wire was accurately inserted and expanded from thin to coarse through the Saber dilator until the endoscope passed smoothly , Again through endoscopic examination of stenosis by the length of the stenosis, the nature of the lesion, to determine the length of the stent placement, diameter and stent position, and finally with a metal stent along the guide wire into the stenosis, to determine the stent position accurate After slowly releasing the stent, all procedures are done separately under endoscopy. Results Twenty-two patients were successfully placed in one case at a time, and the other one was successfully placed for the second time. The symptoms of dysphagia were significantly improved in patients after 2 h, Bracket position accurate, the shape of the two were horn-like, the middle of the narrow diameter of 1.2 ~ 1.5 cm. No serious adverse reactions occurred in all patients. Conclusion Endoscopic esophageal stent placement esophageal stricture is a simple and safe and effective palliative method, which can greatly improve the quality of life of patients.