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目的分析内镜下球囊扩张治疗食管术后吻合口良性狭窄的有效性、安全性及吻合口狭窄程度对球囊扩张效果的影响。方法回顾性分析大连医科大学附属第一医院2006年3月~2013年1月因食管癌和(或)贲门癌行手术治疗后出现吻合口良性狭窄的47例患者,对患者术后出现吞咽困难的时间、程度、球囊扩张次数及并发症等项目分析。结果 47例患者中2例患者由于重度瘢痕狭窄而造成吻合口闭塞,无法放入导丝进行扩张治疗。余45例患者中,治愈率为57.78%,有效率100%,且吻合口轻度狭窄组患者的治愈率较中度及重度狭窄组高,而中度组及重度组患者治愈率的差异未见明显统计学意义。吻合口轻度、中度、重度狭窄组患者球囊扩张1-3次治愈率分别为69.2%、17.6%、6.7%,扩张治疗6次及以上的治愈率分别为92.3%、52.9%、33.3%。47例患者扩张术后均未出现大出血、穿孔等严重并发症。其中23例患者扩张后出现胸骨后疼痛,7例患者出现烧心感,未予特殊处理,上述症状均可自行缓解。结论内镜下球囊扩张治疗食管术后吻合口良性狭窄的临床疗效确切且安全,狭窄出现早期行球囊扩张效果更佳。
Objective To analyze the effect of endoscopic balloon dilatation on the treatment of benign esophageal stricture after esophagectomy, its safety and degree of anastomotic stenosis. Methods A retrospective analysis of 47 patients with benign throat stenosis after surgical treatment of esophageal cancer and / or cardia cancer in the First Affiliated Hospital of Dalian Medical University from March 2006 to January 2013 was retrospectively analyzed. Time, degree, number of balloon dilatation and complications such as project analysis. Results Two of the 47 patients had anastomotic occlusion due to severe stenosis and could not insert the guide wire for dilation. The remaining 45 patients, the cure rate was 57.78%, the effective rate of 100%, and the anastomotic mild stenosis group, the cure rate than the moderate and severe stenosis group, and moderate and severe group of patients with no difference in the cure rate See obvious statistical significance. The curative rates of 1-3 times of balloon dilatation in patients with mild, moderate and severe stenosis were 69.2%, 17.6% and 6.7%, respectively, and the cure rates were 92.3%, 52.9% and 33.3 %. No significant bleeding, perforation and other serious complications occurred in 47 patients after dilation. Twenty-three of these patients developed post-sternal pain after expansion, and seven patients experienced heartburn without any special treatment. The above symptoms were relieved spontaneously. Conclusion Endoscopic balloon dilatation for the treatment of anastomotic benign esophageal stricture clinical efficacy is exact and safe, stenosis appeared early balloon dilatation better.