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目的：观察和评价内镜下放置食管镍钛记忆金属带膜支架，姑息治疗晚期食管癌吞咽困难和食管气管瘘 /纵隔瘘的疗效、并发症及对生存期的影响。方法：治疗组胃镜下（部分进导丝时合用 X线监视）放置国产和进口镍钛记忆金属带膜支架 21例。共放置支架 25枚，其中国产 21枚，进口 4枚。对照组为我院收治的 27例晚期食管癌吞咽困难患者，行胃造瘘和静脉营养姑息治疗。结果：治疗组 24枚支架安置定位准确，扩张满意， 1枚位置偏高 1.0 cm。食管最狭窄处内径由 (1.86± 2.69) mm扩至 (13.91± 1.81) mm，食管气管瘘／纵隔瘘被覆盖阻断。吞咽困难评级（ 0～ 4级）由平均 3.48± 0.75降至 0.90± 0.54。术后一周生活质量评分（ Karnofsky）平均提高 30.09± 5.08。治疗组和对照组的半年生存率为 71.43％与 11.11％， 1年生存率为 14.29％与 0，中位生存期为 7个月与 3个月， Log- rank检验，两组差异有统计学意义（ P<0.0001)结论：该方法简便、准确、安全，明显改善吞咽困难，提高生活质量，延长生存期。
Objective: To observe and evaluate the efficacy, complications and survival time of palliative treatment of late esophageal dysphagia and esophageal tracheal/mediastinal fistula with endoscopic placement of esophageal nickel-titanium memory metal stents. Methods: In the treatment group, 21 cases of domestic and imported nickel-titanium memory metal-membrane stents were placed under gastroscope (parts of the guide wire combined with X-ray monitoring). A total of 25 stents were placed, including 21 made in China and 4 imported. In the control group, 27 patients with dysphagia with advanced esophageal cancer admitted to our hospital were treated with gastrostomy and venous nutrition. Results: In the treatment group, 24 stents were accurately positioned and expanded satisfactorily, with 1 position being 1.0 cm high. The inner diameter of the narrowest part of the esophagus increased from (1.86±2.69) mm to (13.91±1.81) mm, and the esophageal tracheal/mediastinum was covered and blocked. The rating of dysphagia (grade 0 to 4) decreased from an average of 3.48±0.75 to 0.90±0.54. After a week of operation, the Karnofsky quality score increased by an average of 30.09±5.08. The six-year survival rates in the treatment and control groups were 71.43% and 11.11%, the one-year survival rates were 14.29% and 0, and the median survival time was 7 months and 3 months. Log-rank test showed statistical difference between the two groups. Significance (P<0.0001) Conclusion: This method is simple, accurate, and safe. It significantly improves dysphagia, improves quality of life, and prolongs survival.