電子氣管鏡用于食管嚴重狹窄支架置入的效果觀察

游柳生+陳長旦+余崢

【摘要】 目的：探討氣管鏡用于食管嚴重狹窄病例支架置入的可行性與優越性。方法：將胃鏡無法通過的食管嚴重狹窄的患者共34例，分為實驗組12例在Olympus-BF260電子氣管鏡直視下置入食管支架；對照組22例用普通胃鏡在X線透視下行食管支架置入術。結果：實驗組12例患者均一次性成功放置食管支架，成功率100%，操作時間相對短，并發癥少，支架位置準確；對照組22例，成功置入16例，成功率72.7%，出現并發癥4例。結論：電子氣管鏡代胃鏡行食管支架置入術，操作時間短，成功率高，并發癥少，支架定位精確；且無需在X光機，不對醫務人員造成輻射損害，因此電子氣管鏡代胃鏡用于食管嚴重狹窄支架置入優點多，有氣管鏡的醫院均可開展此項工作。

【關鍵詞】 電子氣管鏡； 食管嚴重狹窄； 支架

Effect Observation on Stent Placement for the Cases with Serious Esophageal Stricture under Electron Bronchoscope/YOU Liu-sheng， CHEN Chang-dan， YU Zheng.//Medical Innovation of China，2014，11（28）：040-042

【Abstract】 Objective： To explore the feasibility and superiority of stent placement for the cases with serious esophageal stricture under Olympus-BF260 electron bronchoscope. Method： 34 patients with serious esophageal stricture which electron gastroscope could not get through， among whom 12 cases of experiment group were assigned to be placed metal stent under electron bronchoscope， 22 cases of control group were assigned to undergo metal stent placement under electron gastroscope and X-ray. The operation time， complication， success rate and stent positioning were observed. Result： Stent placement was successful in all patients of experiment group at the first time， and the success rate was 100% and the operation time， complications was less than control group， and stent positioning was more accurate than control group. 16 cases in total 22 cases of control group was successfully placed stent with 4 cases of complication. Conclusion： The metal stent placement under electron bronchoscope is safe and effective with accurate positioning for the patients with serious esophageal stricture.

【Key words】 Electron bronchoscope； Serious esophageal stricture； Stent

First-authors address： Ningde Municipality Hospital Affiliated Fujian Medical University， Ningde 352100， China

doi：10.3969/j.issn.1674-4985.2014.28.014

我國是食道癌的高發國家，目前對食道癌首選的治療方法是手術和放射治療，但由于食道癌早期癥狀多不明顯，發現時多已進展至食管癌晚期，失去手術治療時機。一旦癌組織堵塞管腔，患者不能進食，引起患者營養不良，加重惡病質直接導致死亡；部分患者因食管癌術后放療及手術瘢痕引起吻合口狹窄。食管支架置入可以改善良惡性食管狹窄患者的吞咽困難，改善患者營養狀況，是各種原因食管狹窄的重要治療手段[1-2]；而常規胃鏡無法通過的食管嚴重狹窄患者，食管支架置入相對困難。本院2011年1月-2014年5月用Olympus- BF260電子氣管鏡代替胃鏡給食管嚴重狹窄（常規胃鏡無法通過）患者放置食管支架12例，取得了良好效果，現報告如下。……