摘要
目的探讨可回收Sigma支架治疗气管食管瘘的可行性和优越性。方法用介入或内镜两种方法，为19例病人将支架置入食管或（和）气管内，封堵瘘口。结果17例食管癌、2例良性疾病病人，共放38个支架（气管19个，主支气管1个，食管18个）。2例仅放1个气管支架，15例放双支架（均为管形11例，气管用分叉形4例），2例放3个支架。1次放置成功35个，取出重放3个。放置后第2～4d正常经口进食。除1例仅放置气管支架者，术后有少量造影剂渗入气管，但没有症状，其余18例造影显示气管食管瘘完全封闭。随访3个月至3年，10例健在，最长已18个月。9例死亡，生存2周至12个月，中位生存5．8个月。死于肺部感染1例、大出血1例、肿瘤广泛转移7例。结论可回收Sigma支架通体覆膜，因管口与管身直径一致，克服了记忆合金支架的金属喇叭口明显刺激管壁肉芽增生狭窄，该支架易于回收，可保证放置准确。能有效治疗良、恶性疾病造成的气管食管狭窄和气管食管瘘。
Objective To evaluate the feasibility and advantage of using withdrawable Siam steat for the treatment of tracbeoesophageal fistular. Methods The stents were placed into trachea or/and esophagus by interveational or/and endoscopic technique. Results Esophageal conearin 17 and benign disease in 2. Totally 38 stents were placed in 19 eases of patients （trachea 19, main bronchus 1, esophagus 18）. Only one tracheal steat was placed in 2 eases. Two stentts（one in trachea, another in esophagus） were placed in 15 cases （ 11 cases with 2 tubular type steat, 4 cases with one tubular and one bifurcated type stent）. Three stents were placed in 2 cases. One stage placement of the stem in 35, with＆awed the stem and reinserted again in 3. All the patients have normal meal 2 - 4 days postoperatively. Only one patient had a little contrast in the wachea during X-ray exam but without symptoms, the fistulae completely sealed in 18 cases. Follow-up was fron 3 months to 3 year. 10 patients were still alive the longest survival is 18 months. There were 9 deaths. The causes of death were pulmonary infection in 1, hemorrhage in 1, and systemic metastasis in 7 cases. Conclusion Sigma stentt is can effectively treat tracheal or/and esophageal stenosis or fistular.
出处
《中华胸心血管外科杂志》
CSCD
北大核心
2006年第6期401-403,共3页
Chinese Journal of Thoracic and Cardiovascular Surgery
关键词
气管食管瘘
支架
手术后并发症
Tracheoesophageal fistular Stent Postoperative complications
