先天性食管闭锁术后食管狭窄的诊治  

Evaluation of postoperative anastomotic strictures in infants with esophageal atresia

作　　者：贾炜[1] 钟微[1] 张靖[1] 余家康[1] 李瑞琼[1] 何秋明[1] 唐志贤[1] 夏慧敏[1] 

机构地区：[1]广州市儿童医院外科,510120

出　　处：《中华小儿外科杂志》2008年第12期711-713,共3页Chinese Journal of Pediatric Surgery

摘　　要：目的探讨本院9年先天性食管闭锁（esophageal atresia，EA）术后食管狭窄的诊治，期待提高EA患儿治愈率及生存质量。方法随访1999年1月至2007年12月本院收治并手术的53例EA病例，总结术后食管狭窄的诊治情况。结果手术的53例中29例（34．9％）全部经食管造影检查或胃镜直视下确诊为食管狭窄，其中27例（93．1％）扩张后症状缓解。1例（3．5％）放置镍钛合金自膨胀支架2周后治愈。1例（3．5％）出现食管穿孔。结论球囊扩张是治疗EA术后食管狭窄的有效方法；早期诊断、积极有效地治疗食管狭窄能减少患病率，提高生存质量。Objective To evaluate the diagnosis and treatment for postoperative esophageal stricture in children with esophageal atresia. Methods Fifty-three cases with EA who underwent operations from 1999 to 2007 were followed up. The clinical symptoms of dysphagia and the feeling of esophageal foreign body were recorded. The development of patients was evaluated by the standard month-weight list. Patients with the symptoms of dysphagia or the feeling of esophageal foreign body were examined under esophagogram or gastroscope, and treated by balloon dilation. Results Twentynine （34. 94%） patients were diagnosed as anastomotic strictures by X-ray esophagogram or gastroscopy. Twelve cases with mild stricture accepted balloon dilations under gastroscopy, while those with severe stricture were treated by balloon dilation under X-ray esophagogram. The symptoms of 27 （93.10%） cases were significantly relieved after dilation. One case （3. 45%） was cured by a nitinolalloy self-expanding esophageal stent with satisfactory recovery until 2 weeks later. One case （3.45 %） had the complication of esophageal perforation. Conclusions Balloon dilation is an effective method to treat postoperative esophageal stricture. Early diagnosis, closely investigation and actively intervention play an important role in improving life qualities of patients with EA who have the complication of postoperative esophageal stricture.

关 键 词：食管闭锁 食管狭窄 临床诊治 临床治疗 

分 类 号：R686[医药卫生—骨科学]