腔内支架介入治疗全喉术后重度下咽狭窄.docVIP

腔内支架介入治疗全喉术后重度下咽狭窄 彭解人1 宋新汉2 蔡 翔1 郑 珺3 陈良嗣2 付玉贵1 [摘要] 目的 研究腔内支架介入治疗全喉术后重度下咽狭窄的治疗要点。方法 采用腔内支架介入治疗9例全喉术后重度下咽狭窄患者，观察腔内支架治疗的作用。结果 本组患者中，8例放置成功，吞咽困难明显改善，1例放置失败。随访5-36月，安放腔内支架改善了患者 支架 下咽 狭窄 Treatment of hypopharyngeal stricture after total laryngectomy by Interventional therapy with Inner-cavity cradle Peng jieren, Song xinhan, Cai xiang et al. The Second Affiliated Hospital of Zhongshan University, Guangzhou, 510120 【Abstract】To investigate the main points in the treatment of hypopharyngeal stricture after total laryngectomy by interventional therapy with inner-cavity cradle. 【Method】 9 patients of hypopharyngeal stricture after total laryngectomy accepted the interventional therapy with inner-cavity cradle. 【Results】The interventional therapy with inner-cavity cradle succeeded in 8 patients, the difficulty of swallowing was obviously improved immediately after the therapy. The therapy failed in 1 patient. The follow-up period lasted from 5 months to 36 months. For the 8 patients, the inner-cavity cradle helped them to overcome the difficulty of swallowing, gained more time for further treatment. 【Conclusion】A suitable inner-cavity cradle can extend the hypopharyngeal stricture after total laryngectomy, help the patient to overcome the difficulty of swallowing. The therapy is easy to perform, the effect is reliable. It can be a utility treatment for the hypopharyngeal stricture. [key words] cradle hypopharynx stricture 腔内支架介入技术是借助内窥镜和影像学监视下，用特制导管经体内的腔道将支架送至狭窄的部位，作为支撑结构以治疗管腔狭窄、梗阻、局部病变或术后并发症所引起再狭窄的一种新的临床治疗技术[1]。1998年11月-2002年3月我们应用腔内支架介入治疗9例全喉术后重度下咽狭窄的患者，取得了较好的疗效，现分析如下。 材料与方法 1临床资料 1998年11月—2002年3月共收治重度下咽狭窄患者9例；男8例，女1例；年龄56-73岁。其中喉癌全喉切除术后6例，下咽癌全喉切除术后3例。全部患者都已做永久性颈前气管造瘘。本组9例中有3例确诊为肿瘤复发并转移。临床表现为不同程度的吞咽困难，只能吞咽流质，甚至饮水都无法咽下。术前常规进行颈正、侧位X线吞钡照片检查，以了解狭窄的部位和程度(图1,4)。 2材料 广州泰康科技有限公司研制的带膜网格型镍钛记忆合金支架(单喇叭或双喇叭型)，支架规格为直径10-14mm，长度30，40，60mm，支撑力60-80g/mm.360C,恢复温度360C。置入器长60cm，覆盖管外径6-8mm, 定位管外径4-6mm, 芯管外径3-5mm, 三根管均可相对移动，芯管前端装有引导头, 芯管内孔可作引导