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对于已经失去手术机会,放疗无效或手术放疗后严重狭窄的晚期食管癌患者,尽快恢复经口进食,抑制肿瘤生长,减轻患者痛苦,是延长生存时间,提高生存质量的重要措施。我院自1996年3月以来,采用内镜下扩张、支架置入、中药及化疗等综合序贯治疗晚期食管癌狭窄34例,取得满意效果,现报告如下。 1资料与方法 1.1一般资料 本组男24例,女10例;年龄42～79岁,平均59.1岁。经钡餐内镜病理证实食管癌20例,食管贲门癌9例,食管癌术后狭窄2例,放疗后狭窄3例。合并气管瘘3例,肺转移3例,肝转移1例。狭窄位于上段3例,中段23例,下段8例。狭窄所致吞咽困难按标准积分,能进半流(2分)1例,能进流质(3分)13例,滴水难入(4分)18例。所有患者因转移、病灶范围大、严重衰竭等原因而失去手术或再手术机会。
For patients with advanced esophageal cancer who have lost surgery, radiotherapy, or severe stenosis after radiotherapy, restoring oral intake as soon as possible, inhibiting tumor growth and reducing patient suffering are important measures for prolonging survival time and improving quality of life. Since March 1996 in our hospital, 34 patients with advanced esophageal cancer stenosis treated with endoscopic dilation, stenting, traditional Chinese medicine, and chemotherapy have achieved satisfactory results. The report is as follows. 1 Materials and Methods 1.1 General Information The group of 24 males and 10 females; aged 42 to 79 years, mean 59.1 years old. Endoscopic pathology of barium meal confirmed 20 cases of esophageal cancer, 9 cases of esophageal and cardiac cancer, 2 cases of postoperative stenosis of esophageal cancer, and 3 cases of post-radiotherapy stenosis. There were 3 cases with tracheal fistula, 3 cases with lung metastases, and 1 case with liver metastases. The stenosis was located in 3 cases in the upper segment, 23 in the middle segment, and 8 in the lower segment. Dysphagia caused by stenosis was scored according to standard scores, and was able to enter the half-stream (2 points) in 1 case, influent (3 points) in 13 cases, and to have difficulty in dripping (4 points) in 18 cases. All patients lost surgery or re-operation because of metastases, large lesions, and severe failure.