42例内镜下带膜支架置入治疗食管癌放疗后 食管气管瘘的效果观察

42 cases observation of covered stent placed by endoscopy to treat tracheoesophageal fistula after esophageal radiotherapy

摘要:

目的 观察内镜下带膜支架置入治疗食管癌放疗后食管气管瘘的效果。方法 该组资料选择2009年12月～2012年12月该科门诊或病房收治的食管癌放疗后合并食管气管瘘的患者42例，术前确定食管狭窄部位所在位置以及长度、瘘口所在的位置等，麻醉后内镜下置入带膜支架。结果 所有42例患者均一次性成功放置支架，所有瘘口均被成功封堵，未出现吞咽困难或饮水呛咳。其中22例（52.38%）患者术后生存时间超过3个月，13例（30.95%）患者术后生存时间超过半年，7例（16.67%）患者术后生存时间超过一年。结论 内镜下采用带膜支架置入治疗食管癌放疗后食管气管瘘操作难度小，成功率高且安全系数大，能有效封堵瘘口，快速缓解吞咽困难以及呛咳等症状，明显改善患者的生存质量。值得临床推广。

Abstract:

【Objective】 To observe the effect of covered stent placed by endoscopy to treat tracheoesophageal fistula after esophageal radiotherapy. 【Methods】 42 cases of patients with tracheoesophageal fistula after esophageal radiotherapy treated in our department from December 2009 to 2012 were selected. The location and length of esophageal stricture site were identified before surgery, and the covered stent was placed by endoscopy after anesthesia taking effect.【Results】 All the patients had stent placed successfully, and fistula blocked, and there were no dysphagia and drinking cough found. 22 cases (52.38%) had survival more than 3 months, 13 cases (30.95%) more than 6 months, 7 cases (16.67%) more than 12 months. 【Conclusion】 It was easy to apply covered stent to treat tracheoesophageal fistula after esophageal radiotherapy by endoscopy, and success rate was high and safety factor was large. The fistula could be blocked effectively, and symptom of dysphagia and drinking cough could be effectively alleviate. Quality of life could be significantly improved. It was worthy of clinical application.