静脉麻醉用于内镜引导沙氏探条扩张治疗食管癌术后狭窄的临床研究  

Clinical research of intravenous anesthesia applied in endoscope-guided savary bougie dilatation for stricture after esophagus cancer operation

作　　者：胡维杰[1] 王利娜[1] 汪晓峻[1] 周斌[1] 

机构地区：[1]解放军八一医院消化内科,南京210002

出　　处：《临床肿瘤学杂志》2008年第6期521-523,共3页Chinese Clinical Oncology

摘　　要：目的:探讨在无痛状态下内镜引导沙氏探条扩张治疗食管癌术后狭窄的安全性与临床疗效。方法:将220例食管癌手术或放射治疗后出现狭窄患者分为两组,115例静脉麻醉后进行扩张患者为麻醉组,同期105例未采用静脉麻醉进行扩张患者为对照组,比较两组扩张效果及安全性。结果:麻醉组中原狭窄部孔隙平均口径0.35cm,平均扩张2.4次/人,平均治疗0.6个疗程/人,扩张6周后112例狭窄部口经>0.8cm,吞咽困难得到改善,有效率97.4%,其中显效为62.6%,3例无效,占2.6%。9例扩张时血氧饱和度<80%(Ⅰ度),6例扩张后出现黑便。1年后80例回访,3例狭窄部口径<0.8cm,出现吞咽困难。对照组中原狭窄部孔隙平均口径0.36cm,平均扩张3.4次/人,平均治疗0.85个疗程/人,扩张6周后99例狭窄部口经>0.8cm,吞咽困难得到改善,有效率94.3%,其中显效为30.5%,6例无效,占5.7%。1例扩张后出现气胸,2例扩张后出现黑便。1年后72例回访,11例狭窄部口径<0.8cm,出现吞咽困难。结论:静脉麻醉与非静脉麻醉状态下用沙氏探条扩张治疗食管癌术后狭窄均安全有效,但前者疗程短,远期疗效更理想。Objective：To study the efficacy and safety of endoscope-guided savary bougie dilatation for stricture after esophagus cancer operation. Methods ： Two hundred and twenty patients who suffered from stricture after esophagus cancer surgery or after radiation therapy were divided into two groups. One hundred and fifteen cases treated with dilatation after intravenous anesthesia belonged to anesthesia group and the other without receiving intravenous anesthesia acted as control to compare the dilatation efficacy and safety. Results：Anesthesia： the average caliber of the original strictured opening was 0. 35cm. The average dilatation kept 2.4 times per person and the average course of treatment was 0. 6 per person. After six weeks of dilatation, 112 cases got improvement in dysphagia with the stricture caliber over 0. 8cm and a effective rate of 97.4%. There were 72 cases with marked effects and 3 with invalid effects which accounts for 2. 6%. During dilatation, the blood oxygen saturation less than 80% occurred to 9 cases. 6 cases were found black stool after dilatation. The return visit of 80 cases after one year showed that the strictured calibers of 3 cases were less than 0. 8cm and dysphagia was also found. Control Group. the average caliber of the original strictured opening was 0. 36cm. The average dilatation kept 3.6 times per person and the average course of treatment was 0. 85 per person. After six weeks of dilatation, 99 cases got improvement in dysphagia with the stricture caliber over 0. 8cm and an effective rate of 94. 3%. There were 32 cases with marked effects and 6 with invalid effects which accounts for 5.7%. After dilatation, one case was found pneumothorax and 2 cases were found black stool. The return visit of 72 cases after one year showed that the strictured calibers of 11 cases were less than 0. 8cm and dysphagia was also found. Conclusion：Endoscope-guided savary bougie dilatation for stricture after esophagus cancer operation under intravenous anesthesia and non-intravenous anesthesia

关 键 词：静脉麻醉 沙氏探条 扩张 食管狭窄 

分 类 号：R730.56[医药卫生—肿瘤]