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目的探讨食管内支架置入后疼痛的原因及对策。方法入选48例患者,其中食管癌26例,食管癌外科术后肿瘤复发10例,吻合口狭窄6例,食管癌外科术后肿瘤复发伴食管-气管瘘4例,食管癌外科术后吻合口瘘2例。病变范围4~10cm,平均7.2cm病变按吞咽困难分级:Ⅱ级12例,Ⅲ级25例,Ⅳ级11例。所有患者仅单纯食管内支架置入,均未行放射治疗和化疗。结果共置入内支架48枚,所有病例均1次成功,放置后3~10d,梗阻、进食困难症状均明显减轻,2例食管气管瘘患者进食呛咳立即消失。无严重并发症,均有不同程度的胸骨后疼痛。结论食管内支架置入是治疗食管狭窄的有效方法,通过对支架的选择,以及药物控制,胸骨后疼痛均得到有效缓解。
Objective To investigate the causes and countermeasures of pain after esophageal stent implantation. Methods Forty-eight patients were enrolled, including 26 esophageal carcinomas, 10 recurrent tumors after esophageal cancer surgery, 6 anastomotic stenosis, 4 recurrent esophageal-tracheal fistula after esophageal cancer surgery, 4 esophageal-tracheal fistulas, 2 cases of fistula. Lesions range 4 ~ 10cm, an average of 7.2cm lesions classified according to dysphagia: 12 cases of grade Ⅱ, Ⅲ grade 25 cases, Ⅳ grade 11 cases. All patients were treated with simple esophageal stent implantation without radiotherapy and chemotherapy. Results A total of 48 stents were placed in the stent. All the cases were successfully treated in one time. After being placed for 3 ~ 10 days, the symptoms of obstruction and eating were significantly relieved. Two patients with esophageal and tracheal fistula had cough immediately disappeared. No serious complications, have varying degrees of post-sternal pain. Conclusion The placement of esophageal stent is an effective method to treat esophageal stenosis. The choice of stent and drug control can effectively relieve post-sternal pain.