导管导丝技术在消化道狭窄病变治疗中的运用（附67例报道）.docVIP

精品论文 参考文献 导管导丝技术在消化道狭窄病变治疗中的运用（附67例报道） 张文华 周生林 罗文平（解放军第四五二医院放射科 四川成都 610021） 【中图分类号】R57 【文献标识码】A【文章编号】1672-5085（2012）17-0010-02 【摘要】目的 探讨使用泥鳅导丝、血管导管技术在胃、肠镜无法通过的消化系统狭窄病变中建立工作通道从而完成诊疗的效果。方法　对食道、胃、十二指肠及近端空肠、结肠恶性狭窄, 胃、肠镜均不能通过的病例67例。在X线监视下通过递送导管、超滑导丝并使之通过食道、胃、十二指肠、结肠狭窄或阻塞段经交换导管替换软头特硬导丝后由硬导丝引入支架系统将支架送入狭窄段释放或引入减压、营养管。结果　67 例中有64 成功通过并完成后续操作。成功地放置了53个支架。支架置于食道26个，幽门部8 个,胃肠吻合口7 个,十二指肠降段和水平段14个,近端空肠2个，结肠4个。植入十二指肠营养管8根，胃肠减压管6根。另3例在空肠起始以远15cm以上，导丝通过后，因支撑不足而无法完成后续治疗。结论　使用导管、导丝技术完成胃肠镜不能通过的胃肠道狭窄病变放置支架、营养管及减压管时是高效、创伤小立竿见影的方法。 【关键词】导管 导丝 消化道 恶性狭窄 Application of Catheter and Guide Wire Technique in Pathological Changes of Digestive System Stenosis 【Abstract】　Objective To explore the achieved effect with a loach guidewire and the technique of blood vessel catheter accessible to pathologicalchanges of stenosis in the digestive system to establish working passage rather than with gastroscopeent and enterosarcoma. Methods Astroscope and enterosarcoma have not access to esophagus and duodenum as well as to the close tojejunum in the treatment to 67 pateints.Under the supervision of X-ray, a Catheter and a guidewire are sent through esophagus and duodenum, stenosis or blockage of colon; via crossing-over gudiewire in place of extra stiff guidewire with soft head. Then the stiff guidewire introduces supporting frames which is delivered into the stenosis for releasing or introducing lowing pressure and nutrient canal.Result 64 out of 67 patients are practiced in this way. They are successfully placed 57 supporting frames in total: 26 in esophagus,8 in pylorus, 7 in connection between gastroenterostomia, 14 in duodenum, 2 in the section of the small intestine between the duodenum and the ileum, 4in colon.8duodenum nutrient canal, 6 pressure reducer of stomach intestine are respectively embeded. The other three patients havenrsquo;t achieved continuous treatment out of the lack of supporing after guiderwire is through for over 15cm distance from the beginning of jejunum.Conclusion