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可膨式食管支架的应用

Author
Todd H Baron, MD
Section Editor
John R Saltzman, MD, FACP, FACG, FASGE, AGAF
Deputy Editor
Anne C Travis, MD, MSc, FACG, AGAF
Translators
谢正元, 副主任医师

引言

可膨式金属支架目前常用作消化腔道肿瘤(尤其是食管癌)非手术的姑息治疗选择。食管癌通常诊断时已处于晚期，支架在下列患者中可有助于缓和症状：局部不可切除或晚期转移性食管癌患者、功能状态差不能耐受手术和放化疗的患者或初始治疗后局部复发的患者。由于食管梗阻，这些患者通常有体重减轻和吞咽困难。此外，气管食管(tracheoesophageal, TE)瘘(肿瘤本身或其治疗的并发症)可能引起咳嗽和/或误吸。

虽然疗效不及用于远端食管梗阻治疗时，但可膨式金属支架可成功放置在近端或颈段食管恶性狭窄患者中[1]。

食管支架可缓和食管外恶性肿瘤在外部压迫食管引起的吞咽困难。然而，此情况下症状的改善明显不及食管内源性病变患者[2]。此外，自膨式支架正在用于治疗食管良性疾病，如食管漏、食管瘘和顽固性狭窄[3]。

本专题将总结可膨式支架在治疗食管梗阻中的应用，这些梗阻由食管癌和食管外恶性肿瘤外部压迫食管引起。对食管癌内镜下姑息治疗的几种方法和可膨式支架在胃肠道其他部分的使用的一般概述将在别处讨论。 (参见“食管癌的内镜下姑息治疗”和“胃十二指肠恶性梗阻肠内支架舒缓治疗”和“肠内支架治疗结直肠恶性梗阻”和“恶性胰胆管梗阻的内镜下支架置入术”)

支架的类型

可膨式支架分3种类型：金属支架、塑料支架、可生物降解支架。

                     

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Literature review current through: 2017-07 . | This topic last updated: 2016-12-15.
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