双向移动式食管支架的研制与应用分析.doc

The development and application research of bidirectional mobile esophageal stent 【Abstract】 Objective The development of bidirectional mobile esophageal stent and explore it’s clincal application value. Methods Clinical data of 152 patients undergoing esophageal stenting in The 82nd Hospital of the People’s Liberation Army between December,2005 and December,2013 were analyzed retrospectively, becasue of esophageal stricture after radiotherapy. The patients were divided into two groups depend on the types of esophageal stents. Group A as the bidirectional movement Z- stent group, group B as the traditional recyclable Z -stent group. Results Group A,the upper end of the stent restenosis(recycling line is embedded), moved it down first,then moved up ,or recycled it and placed a new stent to re-expansion the stricture.Group B,patients with restenosis, recycling line is embedded, only then placed another stent.Compared with group B,if the stent migration into the stomach(recycling line remained in the fundus of stomach),group A were more easily removed. The patients of group A could observed the changes of esophageal lesions by moving the stent,but the group B should removed the stent.When recycled stent the upper recycling line was broken,the group A could recycle the stent by hooking the under recycling line. Conclusion The mobility of esophageal stent will become a important factor for clinician to choose stent,the bidirectional mobile esophageal stent is likely to become a good choice for benign and malignant esophageal stricture. 【Key words】 Esophageal stent; Z-style; Bidirectional mobile; Restenosis； Migration 2 引 言 食管癌是食管上皮来源的常见消化道肿瘤，居于全球恶性肿瘤第八，在肿瘤 相关致死原因中排名第六。2011年国际癌症研究中心全球癌症统计报告显示[1]： 2008年全世界食管癌新增人数约46.2万，占所有肿瘤发病的4.2%，死亡人数约40.7 万，占所有肿瘤死亡的5.7%。在全球范围内，超过80％的食管癌患者分布在发展 中国家,而中国是食管癌发病率及死亡率均最高的国家，我国每年大约有25万[2] 确诊病例，占全球总发病数一半。我国食管癌患者遍布全国十余个省市，累及人 数近2亿[3]。 如今食管癌的治疗手段主要包括：手术、放射治疗、化疗、内镜下黏膜切除 术（EMR）、光动力治疗(PDT)、分子靶向治疗、支架治疗等，其中手术治疗仍 为首选。食管癌患者早期症状多不典型，大多数患者只有在出现进食困难时才就 医被发