目的 探讨经X线引导下金属内支架置入治疗胃十二指肠梗阻的临床价值.方法18例胃出口恶性梗阻患者,其中胃窦癌4例、胃窦癌术后吻合口复发6例、贲门癌术后幽门梗阻4例、胃恶性淋巴瘤术后1例、胰腺癌3例,所有患者均在X线监视下置入自膨式金属肠道支架.结果18例患者中,共置入支架20枚.16例一次成功置人支架,2例当时未能成功,临时置入十二指肠营养管,待身体一般情况好转并经充分术前准备后,第2次金属支架置入成功,2例梗阻复发置入第2枚支架.所有患者临床有效率为100％,平均生存期超过9个月.未发生严重并发症.结论经X线引导下金属内支架置入治疗胃十二指肠梗阻是一种简单可行、安全有效的方法,同时提高了患者的生活质量及生存时间.%Objective To evaluate the effect of metal stenting guided by X - ray for malignant gastroduodenal obstruction. Methods There were 18 cases of malignant gastroduodent obstruction. The obstructions were caused by gastric antrum cancer in 4 cases, postoperative anastomotic relapse in 6 cases with gastric antrum cancer, postoperative pyloric obstruction in 4 cases with cardiac cancer, postoperative gastric malignant lymphoma in 1 case, and pancreatic cancer in 3 cases. Guided by X - ray, the self - expandable Nitinol stent was implanted through obstruction in all cases. Results Total of 20 stents was used. 16 cases were succeed in one - shot operation. 2 cases who failed in the 1st operation were successful in the 2nd operation after that their general condition was improved by treatment with temporarily implanted duodenum nutrition tract and full preoperative preparation was given. Recurrent obstruction was observed in 2 cases and was relieved by second stent placement. The effective rate was 100% , and the mean survival time exceeded 9 months. No stent - related complications occurred. Conclusion Nitinol alloy network stent guided by X - ray is safety and effective for malignant gastroduodenal obstruction, awhich can improve quality of life and survival time too.
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