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目的探讨金属内支架治疗胃十二指肠恶性梗阻的临床疗效、操作技术及技巧。方法28例胃十二指肠恶性梗阻患者,其中男性19例,女性9例;年龄48~96岁,平均年龄72.4岁。包括胰腺癌12例,胃癌9例,肝癌3例,十二指肠癌1例,胃癌术后狭窄3例。在数字减影血管造影(DSA)引导下经导丝及导管通过狭窄段后造影证实狭窄部位及长度,选择合适的金属内支架置入。结果28例中27例一次置入成功,成功率96.4%。1周后复查支架位置及膨胀良好。置入后给予补液、止血及对症治疗,3 d内进流食,后逐渐进半流食及普食。结论金属内支架置入介入治疗十二指肠恶性狭窄是安全有效的姑息性治疗方法,对不能手术的十二指肠恶性梗阻有很好的缓解作用。
Objective To investigate the clinical effect, operation technique and technique of metal stent in the treatment of malignant gastroduodenal obstruction. Methods Twenty-eight patients with malignant gastroduodenal obstruction, including 19 males and 9 females, aged from 48 to 96 years, with an average age of 72.4 years. Including pancreatic cancer in 12 cases, 9 cases of gastric cancer, liver cancer in 3 cases, 1 case of duodenal cancer, 3 cases of gastric cancer after stenosis. Under the guidance of digital subtraction angiography (DSA) guidewire and catheter through the stenosis after angiography confirmed stenosis and length, select the appropriate metal stent placement. Results Of 28 cases, 27 cases were successfully implanted at one time, with a success rate of 96.4%. Review the stent position and swelling well after 1 week. Into the rehydration, hemostasis and symptomatic treatment, into the 3 d into the flow of food, then gradually into the semi-liquid food and general diet. Conclusion The interventional metal stent implantation in the treatment of malignant stenosis of duodenum is a safe and effective palliative treatment, which has a good relieving effect on inoperable duodenal obstruction.