内镜下扩张及内支架置入治疗食管贲门吻合口狭窄  

Treatment of esophageal cardiac and anastomotic mouth stricture by dilation and implantation of stents under endoscopy

作　　者：束庆文[1] 娄诗金[1] 黄艺[1] 徐政富[1] 朱英夫[1] 

机构地区：[1]安徽省铜陵市人民医院消化科,244000

出　　处：《蚌埠医学院学报》2004年第6期524-526,共3页Journal of Bengbu Medical College

摘　　要：目的 :探讨内镜下扩张及内支架置入治疗食管贲门吻合口狭窄的方法、疗效及安全性。方法 :33例食管贲门吻合口狭窄患者 ,在内镜及X线透视下 ,插入导丝并越过狭窄段 ,以沙氏探条扩张器由细至粗渐扩至 10～ 15mm。恶性狭窄与食管贲门癌术后瘢痕狭窄或术后复发患者 ,在扩张结束后行内支架置入治疗。结果 :33例中 18例行扩张治疗 ,扩张 1～ 2次者 17例 ,1例扩张 4次 ;15例行扩张和内支架置入治疗 ,均 1次扩张与置管成功。术后狭窄程度按Stooler分级下降Ⅱ级者 2 8例 ,Ⅰ级者 4例 ,未下降者 1例。术中、术后无剧烈疼痛、大出血、穿孔等并发症。结论 :内镜下扩张及内支架置入治疗食管贲门及吻合口狭窄近期疗效良好 ,安全性较高。治疗成功的前提是导丝通过狭窄段 ,保证是固定好导丝 。Objective:To study the procedure,effect and safety of treating esophageal cardiac and anastomotic mouth stricture by dilation and implantation of stents under endoscopy.Methods:Thirty-three cases of esophageal cardiac and anastomotic mouth stricture were treated by inserting a lead through the stricture part under endoscopy and X-ray fluoroscopy,then a Savary-Gilliard dilator was used to dilate the stricture part slowly to 10-15 mm.For those who had malignant stricture,post-operative stricture or recurrence of carcinoma,stents were implanted in addition to ditation.Results:Eighteen cases were treated by dilation only,17 of whom received the therapy for one or two times;and 1 of whom four times;15 cases were treated by dilation,as well as implantation of stents.All were successful for once.After operation,the stricture state decreased Ⅱ degreses by Stooler standard in 28 cases,I degree in 4 cases and did not decrease in 1 case.No severe pain,massive haemoorrhage or perfortion occurred.Conclusions:It is effective and safe to treat esophageal cardiac and anastomotic mouth stricture by dilation and implatation of stents under endoscopy.In the operation,we must make sure that the lead goes through the stricture part and is properly fastened;the stricture part is expanded effectively and the stent implanted in place.

关 键 词：食管狭窄 内镜术 扩张术 支架 

分 类 号：R571.1[医药卫生—消化系统] R730.49[医药卫生—内科学]