X线监视下内镜带膜支架置入治疗中晚期食管癌.pdfVIP

医学临床研究 2007年12月 第24卷 第 12期 J Clin Res，Dec．2007。Vol 24。№12 · 论著· X线监视下内镜带膜支架置入治疗中晚期食管癌 甘克定 李化升 王洪乾 黎振林 何才永 (广西玉林市红十字会医院，广西 玉林 537000) [摘要]【目的】比较中晚期食管癌置入带膜支架两种治疗方法的效果。【方法】中晚期食管癌患者69例， 其中采用内镜法置入带膜支架3O例(对照组)，采用X线监视+内镜直视法1入带膜支架39例(观察组)，对 手术时间、术中定位、吞咽困难、并发症、安全性和准确性进行综合比较。【结果】两组手术时间、并发症、安全 性和准确性比较差异无显著性(P0．05)，两组吞咽困难平均分级分别由治疗前3．18级和 3．3O级下降至 治疗后0．83级和0．77级，组内治疗前后比较差异有显著性(PO．01)，对照组在定位上欠准确，观察组在定 位上和安装及调整上均弥补单纯内镜直视下置入支架的不足，效果满意。【结论】中晚期食管癌置入带膜支 架采用X线监视+内镜直视法优于单纯内镜法，方法便捷，安全性好，并发症少，能改善患者症状，提高生活 质量，延长寿命。 [关键词] 食管肿瘤／治疗； 支架； 内窥镜检查 Comparison of Two methods of Covered Stent in the Treatment of Middle-advanced Esophageal Cancer CAN Ke-ding， LI Hua-sheng， WANG Hong—qian，et al(Yulin Red Cross Hospital， Cnmngxi 537000，Ghina) [Abstract][Objective]To compare the clinical efficacy of two methods of covered stent in the treatment of middl~advanced esophageal cancer．[Methods]Sixty nine cases of middle-advanced esophageal cancer were di— vided into control group and observation group．Covered stents were implanted under endoscope in 30 patients (control group)．Covered stents were implanted under fluoroscope and endoscope together in 39 patients(ob— servation group)．The operation duration，intraoperative location，dysphagia，complications and operation safety and accuracy were comprehensively compared in two groups．【Results]There were no remarkable differences in operation duration，complications and operation safety and accuracy in tWO groups(PO．05)． The average degree of dysphagia lowered from 3．18 and 3．30 tO 0．83 and 0．77，and there were remarkable differences in tWO groups(P0。0 1)．The accuracy of intraoperative location in control group was not as good as that in observation group．[Conclusion】Covered stent under fluoroscopic and endoscopic guidance tO— gether is superior to that under endoscopic guidance only used in the treatment of middle-advanced esophageal