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贲门支架置入治疗恶性狭窄的疗效分析

作者:李海青1 张 强1 张学理1 齐晶晶2 郭淑娟2 刘振华2 程 芳2

所属单位:1.河南省新乡市辉县市人民医院肿瘤科 (河南 新乡 453600)2.河南省新乡市辉县市人民医院介入科 (河南 新乡 453600)

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摘要

目的 评价贲门内支架置入治疗贲门恶性狭窄的效果及方法。方法 对本院2008年12月-2017年6月64例贲门癌合并梗 阻的患者,应用贲门内支架置入治疗贲门恶性狭窄,并跟踪随访。结果 本组64例中12例支架植入后无任何不适, 可见正常进食(CR),占18.7%;48例不同程度疼痛不适,但可以正常进食(PR),占75.0%;4例无法耐受,进行改良 支架二次植入后可以流质进食(MR+SD),占6.3%;有效(CR+PR)率为93.8%。结论 应用贲门内支架置入治疗贲门恶性 狭窄疗效可靠,创伤小,安全性高,不失为治疗贲门恶性狭窄的一种重要微创手段,值得临床推广应用。

Objective To evaluate the effect of cardiac stent implantation in the treatment of malignant cardiac stricture. Methods 64 patients with cardiac carcinoma complicated with obstruction treated in our hospital from December 2008 to June 2017 were taken as the research objects. All these patients were given cardiac stent implantation for the treatment of malignant cardiac stricture and followed up. Results Among these 64 patients, 12 patients (18.7%) had no discomfort and visible normal eating (CR) after stent implantation; 48 patients (75%) had different degrees of pain, but they could eat normally (PR), 4 patients were unable to tolerate, but they could be fed with liquid after twice implantation of improved stent (MR+SD), the total effective rate(CR+PR)was 93.8%. Conclusion Cardiac stent implantation which can be used as an important minimally invasive method for the treatment of malignant cardiac stricture, has the advantage of reliable curative effect, small trauma and high safety. Therefore, it it is worthy of clinical application.

【关键词】贲门癌狭窄;贲门梗阻;贲门内支架置入术

【中图分类号】R573.7

【文献标识码】A

【DOI】10.3969/j.issn.1009-3257.2019.02.022

前言

贲门狭窄又称为贲门失弛缓症,是食管神经肌肉 功能失调引起,随着疾病发展,其会由良性发展成恶 性,患者吞咽十分困难,营养摄入受到阻碍,生存质 量严重下降,危害患者生命健康,并给患者及其家庭 造成巨大的心理负担和经济压力。临床主要采取手术 治疗贲门恶性狭窄,但传统外科手术及内科保守治疗 很难缓解患者症状,随着医学技术的发展,贲门覆膜 内支架已逐渐应用于临床,全国各地多处医疗机构相 继开展推广,均取得了较好效果[1]。本院所在县级为 贲门癌高发区,每年新发病人数百例,晚期贲门癌患 者出现贲门严重狭窄,过往其治疗无明显进展,自近 年引进DSA并进行全面开展后,获得不错治疗效果, 现报道如下。