The Clinical Application of Nasal Endoscopy in patients with Esophageal Stenosis Stent Expansion_West China Medical Journal

Authors：

REN Zhiqiang ¹ ,  ZHENG Yumei ² , YANG Xiaodong ¹ , WANG Ming ¹ , LONG Wenxiu ¹

1. The Surgery Department, the First Hospital of Jianyan, Jianyang, Sichuan 641400, P.R. China; 2. the First People′s Hospital of Ziyang;

Corresponding author：

ZHENG Yumei, Email: dzq7371@sina.com

Keywords：

经鼻超细胃镜; 食管狭窄; 扩张; 支架

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【摘要】目的 探讨经鼻胃镜在食管狭窄扩张和支架置入术中的作用。方法 2007年10月-2009年3月对28例癌性食管狭窄以及并发食管-气管瘘的患者行PENTAX（EG-1580K）超细经鼻电子胃镜检查，计算插入深度，并进行扩张和支架治疗，在胃镜直视下调节输送器内支架上端的位置，观察扩张效果、支架放置成功率、定位的准确性以及并发症情况。结果全部患者均行扩张治疗，效果良好，支架一次性放置全部成功，定位准确，自膨满意，最狭窄处的内径由（4.8±1.2）mm扩至（12.5±1.5）mm，食管气管瘘被覆盖治疗效果好，患者的吞咽困难评级由3.25±0.58降至0.94±0.59。结论在食管狭窄扩张和支架置入术中应用经鼻超细胃镜患者依从性好，方法简便，安全有效。
【Abstract】 Objective To explore the role of nasal endoscopy in the esophagostenosis expansion and esophageal stent. Methods PENTAX (EG-1580K) ultrafine nasal endoscopy was used in 28 patients (October 2007-March 2009) with esophageal cancer complicated with esophagostenosis and fistula to check the e-calculated insertion depth, stent expansion and the average diameter expansion. The endoscopy was carried under the direct vision with the location of the top bracket in order to ensure the accurate stent placement, all without X-ray assist. The success rates of stent placement, positioning accuracy, as well as complications were evaluated. Results The expansion treatments were successful in all patients with one-off operation. The narrowest part increased from (4.9±1.6) mm to (12.7±1.5) mm, and the esophageal fistula was covered. The rating of dysphagia decreased from 3.15±0.68 to 0.91±0.49. Conclusion Nasal endoscopy is simple, safe and effective in the treatment of ultrafine expansion for esophagostenosis and stent implantation with good compliance.

Citation： REN Zhiqiang,ZHENG Yumei,YANG Xiaodong,WANG Ming,LONG Wenxiu. The Clinical Application of Nasal Endoscopy in patients with Esophageal Stenosis Stent Expansion. West China Medical Journal, 2010, 25(10): 1792-1794. doi: Copy

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11.	姜琦, 徐美东, 姚礼石, 等. 食管支架置入后再狭窄的内镜治疗[J]. 中国内镜杂志, 2006, 12 (11): 1183-1185.
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13.	谷中红, 刘星晨, 代彬, 等. 难扩性恶性狭窄扩张治疗探讨[J]. 中华消化内镜杂志, 2006, 23 (2): 113.
14.	张毓德, 张慕纲, 平育敏, 等. 食管癌和贲门癌20796 例外科治疗经验和远期结果[J]. 食管外科, 2007, 6 (1): 2-5.
15.	张初民, 韩盛玺, 宋立. 内镜直视下食管狭窄的水囊扩张治疗[J]. 中国内镜杂志, 2004, 10 (1): 16-18.
16.	徐福涛. 内镜术的镇静与麻醉[J]. 中华消化内镜杂志, 2002, 18(3): 325-326.

1. 许国铭, 姚银珍, 田青, 等. 鼻胃镜(GIF-N230)临床应用的初步报告[J]. 中华消化内镜杂志, 2000, 17(2): 86-89.
2. 方德娟, 黄秀江, 杨瑾. 经鼻胃镜检查的护理配合[J]. 微创医学, 2007, 2(3): 258-259.
3. 黄秀江, 刘杰民. 超细胃镜经鼻检查的应用研究[J]. 中华消化内镜杂志, 2006, 23(5): 383-384.
4. 姜贵君, 刘彩越, 林朝智. 鼻胃镜经口临床应用1020例[J]. 中华消化内镜杂志, 2002, 19(2): 113.
5. 姜贵君, 朱仲政, 方慧祺, 等. 鼻胃镜联合探条扩张器治疗食管贲门狭窄[J]. 中华消化内镜杂志, 2002, 19(5): 264.
6. 杨仁杰, 张志宏, 黄俊, 等. 被覆支架成形术在食管癌姑息治疗中的应用[J]. 中华放射学杂志, 2005, 49 (7): 161-164.
7. Siersema PD, Schrallwen S, van Blankenstein M, et al. Self2 expanding metal stent for comp licated and recurrent esophagogastric cancer [J]. Gastrointest Endosc, 2007, 54 (5): 579-586.
8. 张明彬, 赵晓晏, 李宜辉, 等. 自膨胀金属支架治疗晚期食管癌吞咽困难26例[J]. 中华消化杂志, 2003, 11 (10): 528-530.
9. 姚礼庆, 徐美东. 消化道支架的临床应用及前景[J]. 中国实用外科杂志, 2002, 22 (10): 583-585.
10. Saranovic DJ, Djuric-Stefanovic A, Ivanovic A, et al. Fluoroscopically guided insertion of self-expandable metal esophageal stents for palliative treatment of patients with malignant stenosis of esophagus and cardia: comparison of uncovered and covered stent types[J]. Dis Esophagus, 2005, 18(4): 230-238.
11. 姜琦, 徐美东, 姚礼石, 等. 食管支架置入后再狭窄的内镜治疗[J]. 中国内镜杂志, 2006, 12 (11): 1183-1185.
12. 张烁, 吕宾, 孟立娜, 等. 食管支架术后再狭窄的成因及处理[J]. 中华消化内镜杂志, 2008, 25 (3): 154-155.
13. 谷中红, 刘星晨, 代彬, 等. 难扩性恶性狭窄扩张治疗探讨[J]. 中华消化内镜杂志, 2006, 23 (2): 113.
14. 张毓德, 张慕纲, 平育敏, 等. 食管癌和贲门癌20796 例外科治疗经验和远期结果[J]. 食管外科, 2007, 6 (1): 2-5.
15. 张初民, 韩盛玺, 宋立. 内镜直视下食管狭窄的水囊扩张治疗[J]. 中国内镜杂志, 2004, 10 (1): 16-18.
16. 徐福涛. 内镜术的镇静与麻醉[J]. 中华消化内镜杂志, 2002, 18(3): 325-326.

West China Medical Journal

The Clinical Application of Nasal Endoscopy in patients with Esophageal Stenosis Stent Expansion

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