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介入技术 >文章正文
[Abstract] Objective: To review the treatments process in the cases suffering from with the some clinic problems related with installed digetive tract stent; to summarize and analyse the cure results.
Metheds: in 139 cases installed digetive tract stent occur some clinic problems, such as the pain ,bleed of digestive/respire tract, refluxing in stent，exfoliation/fall off stent,stent block/obstruction，stricture/narrow of stent , rectum polyp etc. According to the different/various condition/cause to cure/ treatment.
Results: the live quality of them are arised after the treatment，be arised 10.1 of 卡氏mark，lives of them are prolong，average/mean exist/live are over13 months，the longest of lives are over 3 years.
Conclusion: After installed the stent in the cases suffer from digetive tract obstruction/fistula,occuring some clinic problems,these connected with the live of cases , ought to treatment timely, serve as to reduce their suffering/pain and arise their qulity of live.
[Key words] digetive tract obstruction fistula stent install clinic problems treatment
由于种种原因造成消化道梗阻或瘘，经支架置入得以解除或消除，其后出现一些继发性临床问题在所难免。问题的多寡与患者生存期成正相关。选择适当的方法给予及时处理，对于保证患者生存质量、延长生命是非常必要的。本文回顾了139例消化道支架置入后陆续出现的相关临床问题，小结了所采取各种处理方法的临床效果，进行了简要讨论。
1． 材料与方法
1.1临床资料
计139例消化道梗阻患者，梗阻部位见表1。其中肿瘤造成的恶性梗阻110 例，恶性肿瘤切除后吻合口疤痕性狭窄6例，吻合口复发性狭窄10例，恶性肿瘤梗阻合并消化管瘘 13例（食道气管瘘 9例，食道纵隔瘘2 例，直肠阴道瘘 1例，直肠盆腔瘘1 例）。
表1 139患者支架置入部位
部 位 例 数 百分比
食道上段 21 15
食道中段 57 41
下段（贲门） 49 35
胃窦部（幽门） 3 2.2
小肠（12指肠及以远） 4 3
结肠 3 2.2
直肠 2 1.4
均成功置入支架。支架置入后出现的临床问题，见表2。
表2 支架置入后临床问题发生数
病 症 例 数 百分比
疼 痛 67 48.2
出 血 17 12.2
返 流 19 13.6
支架脱落 5 3.6
支架阻塞 13 9.4
再狭窄 17 12.2
直肠息肉 1 0.07