内镜下食管支架置入的并发症

A. I. Ivanov, V. Popov, M. V. Burmistrov
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引用次数: 1

摘要

内镜下食管支架植入术是治疗恶性食管狭窄患者吞咽困难的有效方法。然而,这项技术与许多并发症的风险有关,包括那些致命的生命。这些症状包括出血、再狭窄、支架破碎和破坏、支架迁移、纵隔气肿、食管瘘形成、穿孔、支架被食物堵塞、胸骨后疼痛、胃食管反流改变、气道受压、吸入性肺炎和发热。总并发症发生率为3640%。与支架植入相关的死亡率在3.9%至27.2%之间。然而,由于内窥镜技术的不断进步和现代支架设计的改进,今天有办法将并发症的发生率降到最低。此外,如果早期发现,大多数内镜干预可以有效地控制支架植入术后的绝大多数并发症。优化食管支架的选择,谨慎选择支架相关并发症风险低的患者,是预防并发症、提高支架置入效率的重要问题。评估可能并发症的危险因素,支架的设计及其特点,以及使用现代方法有效管理可能的并发症,可改善无法治愈的食管癌患者的生活质量和持续时间。本文综述了食管胃食管交界处支架术可能出现的并发症、并发症发生的影响因素以及现代有效的纠正和预防方法。
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Complications of endoscopic esophageal stent implantation
Endoscopic esophageal stent implantation is an effective method for dysphagia management in malignant esophageal stricture. However, this technology is associated with the risk of many complications, including those fatal to life. These include bleeding, restenosis, stent fragmentation and destruction, stent migration, pneumomediastinum, the formation of esophageal fistulas, perforations, clogging of the stent with food, retrosternal pain, gastroesophageal reflux changes, airway compression, aspiration pneumonia, and fever. The overall complication rate is 3640%. Mortality rates associated with stenting is between 3.9 and 27.2%. Nevertheless, today there are ways to minimize the incidence of complications due to the constant progress of endoscopic technologies and improvements in the design of modern stents. In addition, most endoscopic interventions can manage the vast majority of complications effectively after stent implantation subject to their early detection. Optimal selection of an esophageal stent and careful selection of patients with a low risk of complications associated with stent implantation are important problems in the prevention of complications to achieve high efficiency of stenting. Evaluation of risk factors for possible complications, the design of stents and their characteristics, as well as using modern methods of effective management of possible complications improves the quality and duration of life in incurable patients with esophageal cancer. The review reflects all possible complications of stenting in esophageal and gastroesophageal junction, factors affecting the occurrence of complications, as well as modern and effective methods of their correction and prevention.
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