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目的：观察和评价Ｇｉａｎｔｕｒｃｏ－Ｚ食管带膜自扩金属支架姑息治疗晚期食管癌吞咽梗阻或合并食管呼吸道瘘／纵隔瘘的疗效及并发症。材料和方法：在Ｘ光及金属食管镜指引下，应用Ｇｉａｎｔｕｒｃｏ－Ｚ食管带膜金属支架姑息治疗晚期食管癌１５例，其中６例合并食管呼吸道瘘，２例食管纵隔瘘。食管扩张器扩张后，安放入支架１６个，长６～１４ｃｍ，直径１８ｍｍ。结果：全部支架安放成功，进入预定位置，支架扩张满意。吞咽困难评级（０～４级）平均从３．３８±０．４０级降至１．１３±０．１４级，食管呼吸道瘘／纵隔瘘被阻断，生活质量评分（Ｋａｒｎｏｆｓｋｙ评分）平均提高２８．４±５．１２。无出血穿孔等严重并发症，６例出现短期胸骨后痛，１例支架下端肿瘤过长，需安放与第一个支架部分重叠的第２个支架。随访至１９９７年３月，１２例死亡，平均生存４．１０±０．８２月，２例仍存活分别已生存４、３月。结论：Ｇｉａｎｔｕｒｃｏ－Ｚ食管带膜自扩金属支架用于姑息治疗恶性食管梗阻，食管呼吸道瘘／纵隔瘘，操作简单、安全、姑息效果好，并发症少，生活质量明显提高。
OBJECTIVE: To observe and evaluate the efficacy and complications of the Gantturco-Z esophageal autogenous expanded metal stent for palliative treatment of esophageal airway spasm/mediastinal fistula in advanced esophageal cancer. Materials and Methods: Under the guidance of X-ray and metal esophagoscopy, 15 cases of advanced esophageal cancer were palliatively treated with the Gianturco-Z esophageal membrane-coated metal stent, of which 6 cases were associated with esophageal airway fistulas and 2 cases with esophageal mediastinal fistula. After expansion of the esophageal dilator, Ann placed 16 stents, 6 to 14 cm long and 18 mm in diameter. Results: All the stents were placed successfully and they were placed in a predetermined position. The stent expansion was satisfactory. The rating of dysphagia (level 0 to 4) decreased from 3.38±0.40 to 1.13±0.14 on average, and the esophageal airway fistula/mediastinum was blocked. The average quality of life score (Karnofsky score) increased by 28%. .4±5.12. There were no serious complications such as bleeding and perforation, 6 cases had short-term sternal back pain, and 1 case had too long a tumor at the lower end of the stent. It was necessary to place a second stent partially overlapping with the first stent. Follow-up to March 1997, 12 patients died, and the average survival was 4.10±0.82 months. 2 patients survived and had survived for 4, 3 months. Conclusion: Gianturco-Z self-expanding metal stent with esophageal membrane is used for palliative treatment of malignant esophageal obstruction, esophageal airway spasm/mediastinal fistula, simple operation, safety, palliative effect, fewer complications, and significantly improved quality of life.