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目的 探讨覆膜金属支架治疗恶性食管气管瘘的效果及并发症。方法 在X线引导下 14例食管气管瘘用国产覆膜支架治疗 ,门诊行食管造影或电话随访。结果 除 1例瘘口封堵不全外 ,其余 13例瘘口完全封堵 ,未发生因操作引起的并发症。 8例进普食 ,6例进半流食 ,12例肺部感染得到控制。并发症 :严重胸痛 3例 ,支架移位致瘘再开放 1例 ,颈动脉及左侧喉返神经受压致头晕及咽麻痹各 1例。 8例病人死亡 ,术后生存时间 1 4～ 12个月 ,平均 4个月。 6例存活 ,术后随访时间 1 0～ 15个月 ,平均 6个月。结论 覆膜自膨式金属内支架治疗恶性食管气管瘘是有效的姑息性治疗手段 ,其操作简单 ,并发症少。
Objective To investigate the effect and complications of stent-graft on malignant esophageal tracheal fistula. Methods Under the guidance of X-ray, 14 cases of esophageal tracheal fistula were treated with domestic stent-graft. The patients underwent esophagectomy or telephone follow-up. Results In addition to a case of incomplete closure of the fistula, the other 13 cases of complete closure of the fistula, did not occur due to complications caused by the operation. 8 cases into the general diet, 6 cases into the semi-liquid food, 12 cases of lung infection was controlled. Complications: 3 cases of severe chest pain, 1 case of stent repositioning fistula reopening, 1 case of dizziness and pharyngeal paralysis caused by carotid artery and left recurrent laryngeal nerve compression. 8 patients died, survival time after 14 ~ 12 months, an average of 4 months. 6 cases survived, the follow-up time was 10 to 15 months, an average of 6 months. Conclusion The treatment of malignant esophageal tracheal fistula with self-expandable metal stent is an effective palliative treatment, which has simple operation and few complications.