[1]茅爱武,方世明,刘诗义,等.覆膜金属支架置入治疗恶性肿瘤合并结肠、直肠瘘[J].介入放射学杂志,2007,(11):751.
　MAO Ai-wu,FANG Shi-ming,LIU Shi-yi,et al.Coated metal stents installation for the treatment of malignant tumors complicated with colonic and rectal fistula[J].journal interventional radiology,2007,(11):751.
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覆膜金属支架置入治疗恶性肿瘤合并结肠、直肠瘘()

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《介入放射学杂志》[ISSN:1008-794X/CN:31-1796/R]

卷:
期数:
2007年11期
页码:
751
栏目:
非血管介入
出版日期:
2007-11-15

文章信息/Info

Title:
Coated metal stents installation for the treatment of malignant tumors complicated with colonic and rectal fistula
作者:
茅爱武; 方世明; 刘诗义; 等
２０００５０上海市长宁区同仁医院介入中心
Author(s):
MAO Ai-wu; FANG Shi-ming; LIU Shi-yi; LIN Qing; JIANG Hao-sheng; JIA Yi-ping; GAO Zhong-du．
Intervention Center，Shanghai Tongren Hospital of Changning Distract，Shanghai２０００５０，China
关键词:
恶性肿瘤; 肠瘘; 支架置入术
分类号:
R７３２
文献标志码:
A
摘要:
目的探讨恶性肿瘤合并结肠或直肠瘘的临床特点及覆膜金属支架置入术的临床价值。方法晚期恶性肿瘤伴结肠、直肠瘘２４例，其中肠癌１６例（６６．７％），胃癌及宫颈癌各２例（８．３％），膀胱、前列腺、卵巢和胆囊癌各１例（４．２％）；肿瘤直接浸润穿瘘９例（３７．５％），放疗后穿瘘１５例（６２．５％）。患者KPS评分３０～６０分，中位值４０分。术前行CT检查，并经肛门插管造影明确瘘口位置、肠管走向、是否合并梗阻以及病灶与邻近组织关系。根据瘘口处肠道情况定制覆膜金属支架置入病变部位，观察瘘口封堵结果，随访并发症以及生存情况。结果实际操作２３例。支架置入技术成功率为９６％（２２／２３），１例因肠袢曲度过于锐利，支架无法释放；临床成功率为９１．３％（２１／２３），２例分别因支架贴壁不良和移位仍存在轻微渗漏现象。随访２８～３６５d，平均生存时间１０９d，中位值９２d。３个月和６个月的生存率分别为５１％和１１％。结论肠瘘常见于胃肠道肿瘤术后或放疗后，是一种预后极差的肿瘤并发症，覆膜金属支架置入术为这类患者提供提高生活质量、延长生存时间的治疗选择。

参考文献/References:

［１］Hooft J，Mutignani M，Repici A，et al．First data on the pal-liative treatment of patients with malignant gastric outlet obstruction using the WallFlex enteral stent：a retrospectivemulticenter study［J］．Endoscopy，２００７，３９：４３４-４３９．
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［５］Choo IW，Do YS，Suh SW，et al．Malignant colorectal obstruc-tion：Treatment with a flexible covered stent［J］．Radiology，１９９８，２０６：４１５-４２１．
［６］Cwikiel W，Anden-Sandberg A．Malignant stricture with colovesi-cal fistula：Stent insertion in the colon［J］．Radiology，１９９３，１８６：５６３-５６４．
［７］Fernandez Lobato R，Pinto I．Rectovesical fistula treated by cov-ered self expanding prosthesis：Report of a case［J］．Dis Colon Rectum，１９９９，４２：８１２-８１５．
［８］Jeyarajah AR，Shepherd JH，Fairclough PD，et al．Effective palliation of a colovaginal fistula using a self expanding metal stent［J］．Gastrointest Endosc，１９９７，４６：３６７-３６９．

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备注/Memo

备注/Memo:
收稿日期：２００７-０８-０６
基金项目：卫生部“十年百项”适宜技术推广项目（０２－０５－０２）；上海市、区县卫生系统百人计划项目（００１１１９０１１）
更新日期/Last Update: 2007-11-15