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目的探讨内镜及X线透视下放置支架治疗食管贲门癌疗效及优缺点。方法选取70例有明确行支架置入治疗的指证的食管贲门癌患者,随机分为两组,内镜支架组35例在内镜直视下行支架置入治疗,X线支架组35例在X线透视下行支架置入治疗,观察疗效及并发症发生情况。结果置入带膜支架54例次,不带膜支架16例次,两组患者支架置入成功率为100.00%,支架膨胀良好,吞咽困难缓解,6例食管支气管瘘患者瘘口均闭合。胸痛、出血术后发生率100.00%,症状轻微,对症处理后在1周左右均缓解。术后随访时间6个月～2年,平均8.97个月,患者置入支架后平均存活时间10.49个月,内镜支架组有1例(2.86%)发生支架移位,1例(2.86%)再狭窄,X线支架组有2例(5.71%)发生支架移位,3例(8.57%)再狭窄,两组患者支架置入成功率、再狭窄率及支架移位发生率比较差异无统计学意义(P﹥0.05)。结论内镜及X线透视下置入支架治疗食管贲门癌均能有效缓解患者吞咽困难症状,两种方法均能准确定位并且放置支架,内镜下放置操作相对简单,但狭窄程度较重时相对痛苦较大,可考虑X线透视下置入支架。
Objective To investigate the efficacy and advantages and disadvantages of endoscopic and X-ray placement of stents in the treatment of esophageal and cardiac cancer. Methods Seventy patients with esophageal and cardiac cancer who had a definite indication of stenting were randomly divided into two groups. 35 cases of endoscopic stent group were treated by endoscopic direct descending stent, and 35 cases of X-stent group were treated with X Line fluoroscopy stents into the treatment, observation of the efficacy and complications. Results There were 54 cases with stent-graft and 16 cases without stent-graft. The successful rate of stent implantation was 100.00%. The stent was well inflated and dysphagia was relieved. The fistula of 6 patients with esophageal bronchial fistula were closed. Chest pain, bleeding occurred after surgery 100.00%, mild symptoms, symptomatic treatment in about 1 week after remission. The average follow-up time ranged from 6 months to 2 years (range, 8.97 months). The average survival time after stent placement was 10.49 months. Stent displacement occurred in 1 case (2.86%) in endoscopic stent group and 1 case (2.86% Two cases (5.71%) underwent stent-graft and three cases (8.57%) restenosis after stent restenosis. There was no significant difference in the success rate of stent implantation, restenosis rate and stent displacement between the two groups Significance (P> 0.05). Conclusion Endoscopic and X-ray stenting in the treatment of esophageal and gastric cardia cancer can effectively alleviate the symptoms of dysphagia in patients with both methods can be accurately positioned and placed stent, endoscopic placement is relatively simple, but when the degree of stenosis relative Big pain, consider X-ray into the stent.