摘要
目的探讨经内镜介入治疗胃肠道癌性梗阻的可行性与临床疗效。方法总结分析在X线辅助下经内镜介入治疗32例胃肠道癌性梗阻患者的临床资料。结果32例患者梗阻部位分别为胃出口8例、十二指肠7例、直肠13例、乙状结肠4例。30例(93.7%)放置支架成功,术后1-3d梗阻症状均得到缓解或消除。其中15例胃出口及十二指肠梗阻均为永久性姑息治疗;15例结直肠梗阻中,12例为姑息治疗,3例经内镜治疗解除梗阻后行Ⅰ期肿瘤切除术。1例直肠癌术后复发伴盆腔广泛转移者治疗失败,1例乙状结肠癌广泛转移者术中穿孔而急诊行Hartmann术。随访期间,未发现支架移位;有1例放置十二指肠支架者,术后2个月肿瘤浸润支架远端导致梗阻复发,置入第2根支架后缓解。结论经内镜介入治疗胃肠道癌性梗阻是一种简单可行、经济有效、并发症少的方法。
Objective To evaluate the feasibility and clinical value of endoscopic interventional treatment of malignant gastrointestinal obstruction. Methods With the aid of X ray, 32 cases with malignant gastrointestinal obstruction were treated with endoscopic metal stenting. There were 8 cases with gastric outlet obstruction, 7 with duodenal obstruction, 13 with rectal obstruction, and 4 with sigmoid obstruction. Results Among the 32 patients, metal stenting was successfully performed in 30 cases （93.7%）, and obstructive symptoms were relieved within 1 - 3 days. Metal stent placement was permanent in 15 cases with gastric outlet or duodenal obstruction. Twelve cases with colorectal obstruction received stent placement as palliative treatment, while other 3 cases underwent subsequent elective surgical resection. Metal stent placement failed in one case with recurrent rectal carcinoma, and perforation occurred in another one case with wide spread metastatic sigmoid colon carcinoma and Hartmann operation was performed. During the foUow-up period, no stent migration was detected. Conclusion Endoscopic interventional treatment of malignant gastrointestinal obstruction is a feasible, safe, effective and well tolerated method. It can reduce the patients＇ trauma and pain, and improve the quality of life.
出处
《中华胃肠外科杂志》
CAS
2006年第1期46-49,共4页
Chinese Journal of Gastrointestinal Surgery
关键词
内镜检查
介入治疗
胃肠肿瘤
肠梗阻
Endoscopy
Interventional treatment
Gastrointestinal neoplasms
Intestinal obstruction
