CAJ | 학술논문

目的分析和探讨临时性覆膜支架在治疗贲门失迟缓症时的不良因素和解决的方法方法选择39例食道贲门失迟缓症患者,男21例,女18例,共治疗43次.年龄最大64岁,最小15岁,病程最长27年,最短1年.全部病例经食道钡餐检查,狭窄小于5 mm以下,胃镜病理检查良性.支架选用国产覆膜可回收自膨式支架,采用一步法置入.支架置入时间2周或者3周.术后对症处理及口服0.9%NS 250 ml加庆大霉素8万单位,3次/d.连续3 d.结果全部病例支架置入一次成功,有2例10 d内支架滑入胃内,其中1例取出后重新置入,另一例未再置入;1例12天时取出.取出支架后复查食道钡餐,食道均有不同程度扩张.术后半年内复发8例,其中两例行外科手术治疗,4例再行食道内支架治疗.其余效果较稳定,最长已达79个月未再做治疗.手术时无食管破裂,大出血等严重并发症发生.结论通过对39例经食道内支架治疗患者的分析,食道内支架治疗贲门失迟缓症时,通过对患者饮食习惯的控制、年龄的选择,支架大小的选择,可以提高治疗的有效率,降低病情的复发.
목적 분석화탐토림시성복막지가재치료분문실지완증시적불량인소화해결적방법 방법 선택39례식도분문실지완증환자,남21례,녀18례,공치료43차.년령최대64세,최소15세,병정최장27년,최단1년.전부병례경식도패찬검사,협착소우5 mm이하,위경병리검사량성.지가선용국산복막가회수자팽식지가,채용일보법치입.지가치입시간2주혹자3주.술후대증처리급구복0.9%NS 250 ml가경대매소8만단위,3차/d.련속3 d.결과 전부병례지가치입일차성공,유2례10 d내지가활입위내,기중1례취출후중신치입,령일례미재치입;1례12천시취출.취출지가후복사식도패찬,식도균유불동정도확장.술후반년내복발8례,기중량례행외과수술치료,4례재행식도내지가치료.기여효과교은정,최장이체79개월미재주치료.수술시무식관파렬,대출혈등엄중병발증발생.결론통과대39례경식도내지가치료환자적분석,식도내지가치료분문실지완증시,통과대환자음식습관적공제、년령적선택,지가대소적선택,가이제고치료적유효솔,강저병정적복발.
Objective To analyse and explore the adverse factors and solutions on the temporary stent-graft treatment of esophageal achalasia disease. Methods 39 patients with diagnosis of esophageal achalasia disease of were studied. There were male group(21 cases)and female group(18 cases) ,ranging from 15 to 64-years-old. The longest disease course was 27 years and the shortest was only 1 year. They have been treated 43 times. All cases have been esophagealled by barium med examination(narrow less than 5 mm)and Endoscopic biopsy(benign) confirmed. To select China-made recyclable plastic self-expanding stent, to adopt one-step into the esophagus, Stent stay for 2 weeks or 3 weeks. Symptomatic treatment after operation, oral 0.9% NS. 250 ml gentamicin plus 80,000 units,3 times/day and 3 consecutive days. Results All cases of stent placement was successful only once. During the treatment,2 cases stent slided into stomach in 10 days, 1 case of them remove the stent and then placement again, and another case didn't replace. In addition, one case removed the stent in 12th days. To remove the stent and then review esophageal barium med examination ,which have been confirmed the esophagus were expandment in vary degrees. After six months, 8 cases of recurrence, two of which adopted routine surgical treatment ,4 cases of re-line treatment of esophageal stent. The remaining patients effect were sta-ble,reached a maximum of 79 months not to treat again. In the process of implementation during the operation, there have not severe complications such as esophageal rupture ,bleeding. Conclusion To analyse the 39 cases transesophageal treatment of patients with stents, we can seen the esophageal stents in the treatment of esophage-al achalasia disease is safe and effective. Through controlling the eating habits of patients, choosing to the pa-tients and the adjustment to the esophageal stent sizes, we can concluded the treatment can improve the efficien-cy and then reduce recurrence of the disease.