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〔目的〕探讨应用血管性介入的病因治疗和非血管性介入的病症治疗相结合的方法治疗消化道恶性梗阻 ,以提高晚期肿瘤伴消化道梗阻患者的生活质量 ,延长其生存时间。〔方法〕因恶性肿瘤浸润、压迫所致消化道梗阻病例215例 ,梗阻部位分别为食管 ,胃、十二指肠及空肠(包括胃肠吻合口) ,结肠和直肠以及胆道。分别采用经口(食管 ,胃、十二指肠及空肠)、经肛门(结肠和直肠)以及经皮、肝(胆道)放置自膨式金属支架 ,并对其中154例采用Seldinger氏穿刺行肿瘤供血动脉插管介入化疗。〔结果〕215例共放置支架282枚 ,其中食管支架119枚 ,胃十二指肠支架83枚 ,结肠和直肠支架21枚以及胆道支架59枚。支架放置后所有病例梗阻症状均获缓解或减轻。接受双介入治疗者支架通畅维持时间较单纯支架治疗者长 ,生存时间亦较后者明显延长。〔结论〕动脉内灌药内支架放置双介入是标本兼治治疗消化道恶性梗阻的有效的姑息性疗法。
[Objective] To explore the treatment of malignant obstruction of digestive tract by combining the etiological treatment with vascular intervention and the treatment of non-vascular interventional disease so as to improve the quality of life and prolong the survival time of patients with advanced tumor and gastrointestinal obstruction. [Methods] 215 cases of digestive tract obstruction caused by malignant tumor infiltration and oppression were esophagus, stomach, duodenum and jejunum (including gastrointestinal anastomosis), colon, rectum and biliary tract. (Esophagus, stomach, duodenum and jejunum), transanal (colon and rectum), percutaneous, and hepatic (biliary) stents were placed respectively. Of 154 patients, Seldinger’s Artery arterial catheterization chemotherapy. [Results] A total of 215 stents were placed in 282 stents, including 119 esophageal stents, 83 gastroduodenal stents, 21 colon and rectal stents and 59 biliary stents. All cases of obstruction symptoms were relieved or alleviated after stent placement. Patients receiving dual interventional treatment had a longer patency and a longer survival time than those treated with stents alone. [Conclusion] Intra-arterial infusion of stent placement in double interventions is an effective palliative therapy for the treatment of digestive tract obstruction.