Objective To observe the role of fully covered nickel-titanium memory alloy stent with external hanging thread and protective tube in improving quality of life in elderly patients with advanced carcinoma of esophagus and cardia.
Methods A total of 68 elderly patients with carcinoma of esophagus and cardia complicated with lumen stenosis were randomly divided into control group and observation group, with 34 cases in each group. The observation group was treated with external hanging thread and protective tubes for fixation on the basis of the control group. The condition of the stent in position was followed up after operation, and classification of dysphagia was scored before and a month after the stent implantation; the nutritional status was evaluated by the Patient-Generated Subjective Global Assessment (PG-SGA), anthropometry and laboratory examination; the quality of life and emotional status of the patients were evaluated by the Karnofsky Performance Status (KPS) and the Patient Health Questionnaire-9 items (PHQ-9).
Results The stents of 68 patients were placed successfully at one time, with a success rate of 100%. After one month of stent placement, there were 5 cases with stent displacement in the control group, but no stent displacement was observed in the observation group. Before treatment, the scores of dysphagia in the control group and the observation group were (3.18±0.89) and (3.20±0.92) respectively, which were significantly higher than (1.69±0.91) and (1.70±0.82) respectively at one month after stent implantation (P < 0.01). Before treatment, the scores of PG-SGA in the control group and the observation group were (2.81±0.67) and (2.74±0.54) respectively, which were separately higher than (1.21±0.73) and (1.20±0.93) respectively at one month after stent implantation (P < 0.01). The results of laboratory examination and anthropometry revealed that the nutritional status of patients was improved after treatment. Before treatment, the scores of KPS in the control group and the observation group were (69.77±11.23) and (70.23±12.11) respectively, which were separately higher than (58.84±7.95) and (59.12±7.63) at one month after stent implantation (P < 0.01). Before treatment, the scores of PHQ-9 in the control group and the observation group were (14.04±4.73) and (13.98±4.86) respectively, which were separately higher than (8.06±1.09) and (7.97±1.17) at one month after stent implantation (P < 0.01).
Conclusion The placement of fully coated nickel-titanium memory alloy stent is an effective palliative treatment for advanced carcinoma of esophagus and cardia, which can improve the dysphagia and nutritional status of patients, and improve the quality of life. Additional use of external hanging thread for fixation can avoid the occurrence of stent displacement, and additional use of protective tubes can alleviate the cutting injury caused by external hanging thread.
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