临床普外科电子杂志 ›› 2022, Vol. 10 ›› Issue (4): 7-.

• • 上一篇    下一篇

食管支架与经皮胃造瘘在食管梗阻中的应用对比研究

  

  1. 仁怀市人民医院 胸外科,贵州 遵义 564500
  • 出版日期:2022-10-01 发布日期:2023-01-13

Comparative study of esophageal stent and percutaneous gastrostomy in esophageal obstruction

  1. Chest Surgery Department of Renhuai People's Hospital, Guizhou Zunyi 564500, China
  • Online:2022-10-01 Published:2023-01-13

摘要:

目的 分析探究食管梗阻患者采用食管支架与经皮胃造瘘治疗的效果。方法 选取仁怀市人民医院2020 年1 月至2021 年12 月收治的70 例食管癌梗阻患者,按照治疗方法的不同分为两组,每组35例。对照组患者选择置入食管支架治疗,研究组患者选择计算机断层扫描引导下经皮胃造瘘方法,对比两组患者的营养指标水平、相关指标恢复和并发症情况。结果 术后,研究组患者的体质量指数、血清白蛋白、前白蛋白、血红蛋白水平均高于对照组,差异有显著性(P < 0.05)。研究组患者的手术用时短于对照组,术中出血量少于对照组,且术后疼痛评分低于对照组、生活质量评分高于对照组,差异均有显著性(P < 0.05)。术中两组患者耐受度均较高,手术均较顺利进行,手术成功率100%,未发生致命性的严重并发症,术后患者病情和生命体征稳定。两组患者均未出现造瘘交换导管脱落、大出血、胃肠道损伤等严重并发症。研究组患者并发症总发生率20.00%(7/35),对照组为22.86%(8/35),差异无显著性(χ2=3.426,P=0.386)。结论 食管梗阻治疗中,经皮胃造瘘术较食管支架治疗能更有效改善患者营养指标,且临床安全性较高。

关键词: 食管梗阻, 食管支架, 经皮胃造瘘, 应用效果

Abstract:

Objective To analyze the effect of esophageal stent and percutaneous gastrostomy in the treatment of esophageal malignant obstruction. Method 70 patients with esophageal cancer obstruction admitted to Renhuai People's Hospital from January 2020 to December 2021 were selected and divided into two groups according to different treatment methods, 35 patients in each group. The patients in the control group were treated with esophageal stent implantation, while the patients in the study group were treated with percutaneous gastrostomy under the guidance of computed tomography. The level of nutritional indicators, recovery of related indicators and complications were compared between the two groups. Result The body mass index, serum albumin, prealbumin and hemoglobin levels in the study group were significantly higher than those in the control group (P < 0.05).

The operation time of the patients in the study group was shorter than that in the control group, the amount of intraoperative bleeding was less than that in the control group, and the postoperative pain score was lower than that in the control group, and the quality of life score was higher than that in the control group, with significant differences (P < 0.05). The patients in both groups had a high tolerance during the operation. The operation was carried out smoothly. The success rate of the operation was 100%. There were no fatal serious complications. The patient's condition and vital signs were stable after the operation. There were no serious complications in the two groups, such as fistula exchange catheter falling off, massive hemorrhage, gastrointestinal injury, etc. The total incidence of complications in the study group was 20.00% (7/35), and 22.86% (8/35) in the control group,there was no significant difference (χ2=3.426,P=0.386). Conclusion In the treatment of esophageal obstruction, percutaneous gastrostomy is more effective than esophageal stent in improving patients' nutritional indicators, and has higher clinical safety.

Key words: Esophageal obstruction, Esophageal stent, Percutaneous gastrostomy, Application effect