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目的探讨上段食管癌狭窄内支架治疗的可行性及技术环节。方法采用泛影葡胺或钡剂口服造影了解病变上段与咽缩肌的距离,内镜直视下定位置入食管支架治疗38例。结果所有患者均成功置入食管支架,放置的支架上段距门齿18cm9例,18.5cm4例,19cm12例,20cm13例。所有患者支架放置后均有异物感且持续时间相对较长,但多能耐受,对生活不构成影响。追踪观察的31例患者在生存期内都能保持消化道通畅。平均生存时间1年7个月。结论上段食管癌性狭窄放置支架难度虽然很高,但只要能确保咽缩肌功能不受影响,金属内支架置入治疗仍是可行的且能明显提高生存质量。
Objective To investigate the feasibility and technical aspects of the treatment of upper esophageal stenosis stent. Methods The distance between the upper segment of the lesion and the pharyngeal constrictor muscle was determined by oral contrast with meglumine diatrizoate or barium. Thirty-eight patients underwent esophageal stent placement under endoscopy. Results All patients were successfully placed into the esophageal stent. The upper part of the stent was placed 18 cm away from the incisors, 9 in 18.5 cm, 12 in 19 cm, and 13 in 20 cm. All patients had foreign body sensation after placement and the duration was relatively long, but more tolerable, does not affect life. Follow-up observation of 31 patients in the survival period can keep the digestive tract patency. The average survival time of 1 year and 7 months. Conclusions Despite the high difficulty in stenting of esophageal stenosis in the upper segment, placement of metal stents is still feasible and can significantly improve quality of life, provided that the function of the pharyngeal constrictor is not affected.