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目的探讨125I粒子覆膜支架对恶性食管气管瘘的疗效。方法在内镜指引下先将食管狭窄部位扩张,根据病变的大小通过治疗计划系统(treatment plan system,TPS)计算出放射粒子的剂量,选择合适的特制覆膜粒子支架,按一定规律装上125I粒子,对19例食管气管瘘患者进行治疗。内镜直视结合X线透视,将125I粒子覆膜支架置入狭窄部位和瘘口处。结果19例患者皆1次置入支架成功,无放射粒子脱落,瘘口完全封堵,呛咳症状立即消失。按stooler分级,治疗后0级13例,1级4例,2级2例。患者吞咽困难持续缓解时间3~15个月,平均7.3个月。存活时间4~18个月,平均7.8个月,尚有5例存活。结论125I粒子覆膜支架治疗恶性食管气管瘘的一种疗效好,成功率高,痛苦小,且易于普及的姑息治疗方法。
Objective To investigate the curative effect of 125I-covered stent on malignant esophageal tracheal fistula. Methods The esophageal stenosis was first expanded under the guidance of endoscopy. The dose of radioactive particles was calculated through the treatment plan system (TPS) according to the size of the lesion, and the appropriate special coated granule scaffold was selected. The 125I 19 patients with esophageal tracheal fistula were treated. Endoscopic combined with X-ray fluoroscopy, the 125I-stent-graft into the stenosis and fistula Department. Results All the 19 patients were successfully placed in the stent once. No radioactive particles were shed, the fistula was completely blocked and the symptoms of cough disappeared immediately. Stooler grading, 0 after treatment in 13 cases, 1 in 4 cases, 2 cases in 2 cases. Patients with dysphagia sustained relief of 3 to 15 months, an average of 7.3 months. Survival time 4 to 18 months, an average of 7.8 months, there are 5 cases of survival. Conclusion 125I particle covered stent in the treatment of malignant esophageal fistula is a palliative treatment with good curative effect, high success rate, little pain and easy to popularize.