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[目的]观察胃镜测距盲推支架置入术对高位食管癌的临床疗效。[方法]对50例高位食管癌患者采用胃镜测距盲推支架置入术,观察操作成功率、吞咽困难缓解情况、不良反应发生率以及术后生存时间。[结果]50例患者共置入50枚支架,均为一次性置入;支架置入后吞咽困难较治疗前明显缓解(P<0.05)。术后有恶心呕吐症状8例,异物感、轻度胸部胀痛不适感4例,支架移位3例,食团堵塞支架11例,支架上端再狭窄2例。随访24个月内,35例患者死于肿瘤全身转移或全身器官衰竭,且临终前Stoller分级均为Ⅱ~Ⅲ级,无食管穿孔发生。[结论]胃镜测距盲推置入支架介入治疗高位食管癌较胃镜直视法、X线下法具有明显的优势,可有效缓解吞咽困难,患者痛苦小,且易于操作。
[Objective] To observe the clinical effect of endoscopic blind positioning stent implantation on high esophageal cancer. [Method] Fifty cases of esophageal cancer patients underwent blind insertion with gastroscopic distance measurement. The success rate of operation, the relief of dysphagia, the incidence of adverse reactions and the survival time were observed. [Results] A total of 50 stents were placed in 50 patients, all of which were placed in one time. The difficulty of swallowing after stenting was significantly relieved (P <0.05). Postoperative nausea and vomiting in 8 cases, foreign body sensation, mild chest pain discomfort in 4 cases, stent displacement in 3 cases, bolus block stent in 11 cases, stent restenosis in 2 cases. During the 24 months follow-up, 35 patients died of systemic tumor metastases or systemic organ failure, and the pre-death Stoller grading was grade II-III with no esophageal perforation. [Conclusion] Endoscopic treatment of high esophageal cancer by endoscopic blind positioning and stent implantation has obvious advantages over direct gastroscopy and X-ray method, which can effectively relieve the difficulty of swallowing. It is less painful and easy to operate.