临床消化病杂志
臨床消化病雜誌
림상소화병잡지
CHINESE JOURNAL OF CLINICAL GASTROENTEROLOGY
2014年
5期
283-285
,共3页
王晓露%郑林福%陈龙平%许白燕%邓双萍
王曉露%鄭林福%陳龍平%許白燕%鄧雙萍
왕효로%정림복%진룡평%허백연%산쌍평
胃食管交界处腺癌%自膨式金属支架%呑咽困难
胃食管交界處腺癌%自膨式金屬支架%呑嚥睏難
위식관교계처선암%자팽식금속지가%탄인곤난
adenocarcinoma of the gastroesophageal junction%self-expanding metal stents%dysphagia
[目的]探讨自膨式金属支架（SEMS）置入术改善胃食管交界处腺癌患者吞咽困难的价值及安全性。[方法]纳入已失去手术机会或拒绝手术治疗的胃食管交界处腺癌伴吞咽困难患者48例，按患者意愿分为SEMS置入治疗组及不置入SEMS的对照组，记录SEMS置入过程中及之后1周的症状及不良反应，并于3、6、12个月对2组患者进行症状、辅助检查及生存状况随访。[结果]治疗组25例患者，均一次性成功置入SEMS ，在置入过程中未出现明显并发症，其中96.00％（24/25）患者置入支架后吞咽困难症状明显改善；对照组23例经给予促动力药等治疗后，仅8.69％（2/23）症状稍改善；2组比较差异有统计学意义（ P＝0.000）。6个月、12个月的生存率治疗组分别为64.00％、48.00％，对照组分别为30.43％、0％，治疗组的生存时间明显长于对照组（ P＝0.021、0.000）。[结论] SEMS置入术是比较安全的治疗胃食管交界处腺癌吞咽困难的方法，可明显改善患者生活质量并明显延长生存时间。
[目的]探討自膨式金屬支架（SEMS）置入術改善胃食管交界處腺癌患者吞嚥睏難的價值及安全性。[方法]納入已失去手術機會或拒絕手術治療的胃食管交界處腺癌伴吞嚥睏難患者48例，按患者意願分為SEMS置入治療組及不置入SEMS的對照組，記錄SEMS置入過程中及之後1週的癥狀及不良反應，併于3、6、12箇月對2組患者進行癥狀、輔助檢查及生存狀況隨訪。[結果]治療組25例患者，均一次性成功置入SEMS ，在置入過程中未齣現明顯併髮癥，其中96.00％（24/25）患者置入支架後吞嚥睏難癥狀明顯改善；對照組23例經給予促動力藥等治療後，僅8.69％（2/23）癥狀稍改善；2組比較差異有統計學意義（ P＝0.000）。6箇月、12箇月的生存率治療組分彆為64.00％、48.00％，對照組分彆為30.43％、0％，治療組的生存時間明顯長于對照組（ P＝0.021、0.000）。[結論] SEMS置入術是比較安全的治療胃食管交界處腺癌吞嚥睏難的方法，可明顯改善患者生活質量併明顯延長生存時間。
[목적]탐토자팽식금속지가（SEMS）치입술개선위식관교계처선암환자탄인곤난적개치급안전성。[방법]납입이실거수술궤회혹거절수술치료적위식관교계처선암반탄인곤난환자48례，안환자의원분위SEMS치입치료조급불치입SEMS적대조조，기록SEMS치입과정중급지후1주적증상급불량반응，병우3、6、12개월대2조환자진행증상、보조검사급생존상황수방。[결과]치료조25례환자，균일차성성공치입SEMS ，재치입과정중미출현명현병발증，기중96.00％（24/25）환자치입지가후탄인곤난증상명현개선；대조조23례경급여촉동력약등치료후，부8.69％（2/23）증상초개선；2조비교차이유통계학의의（ P＝0.000）。6개월、12개월적생존솔치료조분별위64.00％、48.00％，대조조분별위30.43％、0％，치료조적생존시간명현장우대조조（ P＝0.021、0.000）。[결론] SEMS치입술시비교안전적치료위식관교계처선암탄인곤난적방법，가명현개선환자생활질량병명현연장생존시간。
[Objective]To investigative value and safety of self-expanding metal stents(SEMS)on treat-ment of dysphagia in gastro-oesophageal junction(GEJ)adenocarcinoma patients.[Methods]Forty-eight ca-ses of gastro-oesophageal junction adenocarcinoma patients with dysphagia ,which were all unresectable or refused surgical treatment ,were involved.The patients were divided into treatment group with deploymen-ting SEMS and control group without any therapy.Adverse reactions during and one week after treatment in treatment group were recorded.The follow-up point included 3 months ,6 months ,12 months after de-ployment of SEMS was performed in treatment group and control group ,including symptoms ,auxiliary ex-amination and survival time ,examinations. [Results] Twenty-five patients were successfully implanted SEMS one time ,no serious complications were observed during the process ,nine cases had chest pain ,seven cases showed nausea and vomiting ,but the symptoms were relieved within 1 week after treatment.The dys-phagia in treatment group was improved significantly 96.00% (24/25)after treating.However ,only 8.69%(2/23)of patients in the control group improved after treating with prokinetic drugs and other drugs.The difference between these two groups was significant (P= 0.000).Six-months survival rate in treatment group was 64.00% and twelve-months survival rate was 48.00%.While the survival rate in control group were 30.43% ,0% respectively ,which were significantly lower(Pwere 0.021 and 0.000).[Conclusions] SEMS placement is a relatively safe method for gastro-oesophageal junction(GEJ)adenocarcinoma patients with dysphagia ,and it can significantly improve the quality of life and significantly prolong survival time of patients.
