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目的 探讨镍钛形状记忆合金支架治疗良恶性直肠梗阻的疗效及意义。方法 对 12例恶性肿瘤致直肠狭窄和 1例良性狭窄导致的急慢性直肠梗阻患者实施了支架置入术。支架在冰水中柔软，易压缩，通过手工或乙状结肠镜送至狭窄部位，灌注热水后支架复形扩张。结果 11例患者成功置入， 5 h内恢复了排便。 8例作为永久性姑息治疗， 2例经过充分的肠道准备，择期施行了切除手术， 1例良性狭窄长期带支架维持排便。 2例支架脱落后再次置入。 1例穿孔改行结肠造口。 11例中死亡 6例，生存期 56～ 720 d。其他 5例已存活至今，达 6～ 32个月，无再发肠梗阻。结论 网管状支架能有效地对晚期直肠癌以及具有高危手术因素的患者进行永久性姑息治疗，同时能缓解急性梗阻，避免结肠造口，为择期手术创造条件。配合化疗和免疫治疗，有利于延长患者生存期。
Objective To investigate the curative effect and significance of nickel-titanium shape memory alloy stent on benign and malignant rectal obstruction. Methods Stent implantation was performed in 12 patients with rectal stricture caused by malignant tumor and 1 patient with benign or malignant obstruction caused by benign stenosis. Scaffolds are soft and easy to compress in ice water. They are delivered to the stenosis by manual or sigmoidoscope, and the scaffolding expands after perfusion with hot water. Results 11 patients were successfully implanted and defecation recovered within 5 h. Eight patients were treated as permanent palliative patients. Two patients underwent adequate bowel preparation and underwent elective surgery. One patient with long-term benign stenosis maintained defecation. 2 cases of stent off again after placement. One case of perforation diverted colostomy. Among the 11 patients, 6 died and the survival time was 56 ~ 720 d. The other five cases have survived so far, up to 6 to 32 months, no recurrence of intestinal obstruction. Conclusion Nerve stent can effectively treat patients with advanced colorectal cancer and high risk surgical factors and can ease acute obstruction and avoid colostomy to create conditions for elective surgery. With chemotherapy and immunotherapy, help to prolong the survival of patients.