儿童难治性食管狭窄应用全覆膜支架治疗的并发症及处理对策

发布时间：2018-07-23 14:16

【摘要】：目的探讨应用镍钛合金全覆膜食管支架治疗儿童难治性食管狭窄的并发症及处理对策。方法回顾性分析2009年5月-2016年12月于该院应用镍钛合金网格编织型的覆膜支架治疗9例难治性食管狭窄患儿的临床资料,支架置入术后定期随访,观察患儿支架置入后的效果及并发症等。结果 9例患儿均成功行支架置入术,所有患儿置入后狭窄梗阻症状均得到明显缓解;术后1~7 d所有患儿均有呕吐及不同程度的胸痛症状;1例患儿置入后因哭闹不安不能忍受于术后36 h取出支架;2例于支架取出3个月后出现再狭窄,其中1例并发肉芽组织增生;1例食管穿孔患儿支架置入术1周出现支架移位贴壁不良,原支架取出后重置新支架,2个月后再行支架取出,瘘口愈合。结论镍钛合金全覆膜金属支架治疗儿童难治性良性食管狭窄安全有效,但与支架置入相关的并发症不容忽视,支架个体化设计与并发症的及时处理对提高临床疗效至关重要。
[Abstract]:Objective to explore the complications and treatment of refractory esophageal stricture in children treated with nickel titanium alloy full-covered esophageal stent. Methods from May 2009 to December 2016, the clinical data of 9 children with refractory esophageal stricture treated with Ni-Ti mesh braided stents were retrospectively analyzed. The patients were followed up regularly after stenting. To observe the effect and complications of stent implantation in children. Results Stent implantation was successfully performed in all the 9 cases, and the symptoms of stenosis and obstruction were alleviated significantly in all the patients. On the 1st and 7th day after operation, all the children had vomiting and chest pain symptoms of varying degrees. One patient could not bear to take out the stents 36 hours after implantation because of crying and restenosis. 2 patients developed restenosis 3 months after the removal of the stents. One case with granulation tissue hyperplasia and 1 case with esophageal perforation had poor stents displacement and adhesion at 1 week. After the removal of the original stents, the new stents were resetting, then the stents were removed 2 months later, and the fistula healed. Conclusion Nickel-titanium alloy covered metal stent is safe and effective in the treatment of refractory benign esophageal stricture in children, but the complications associated with stent implantation should not be ignored. It is very important to improve the clinical efficacy of stent individualized design and timely treatment of complications.
【作者单位】：上海市儿童医院消化内科;
【基金】：上海市申康适宜技术联合开发与推广应用项目(No:SHDC12014224)
【分类号】：R725.7

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