内镜下钬激光治疗癌性及瘢痕性食管狭窄99例疗效观察  

Observation of Ho:YAG laser via endoscopy for 99 cases with esophagostenosis caused by carcinoma and scar

作　　者：卢忠生[1] 毛永平[1] 刘庆森[1] 范开春[1] 黄英才[1] 

机构地区：[1]解放军总医院消化科,北京100853

出　　处：《中华理疗杂志》2001年第3期145-146,共2页Chinese Journal of Physical Therapy

摘　　要：目的　回顾分析应用钬激光治疗癌性及瘢痕性食管狭窄的治疗效果及影响治疗效果的因素。方法　钬激光治疗食管狭窄计 99例 ,照射 2 30次。结果　 2 0例镜身可通过的食管贲门癌患者平均治疗 1.8次 (1～ 4次 ) ,有效 17例 ,无效 3例 ;16例镜身不能通过的病例平均治疗 3.7次 (2～ 6次 ) ,有效8例 (3例结合扩张 ) ,8例无效。术后瘢痕性狭窄中 ,狭窄段 <1.0cm 32例 ,平均治疗 1.1次 (1～ 2次 ) ,均有效 ;狭窄段 1.0～ 2 .0cm 16例 ,平均治疗 1.8次 (1～ 3次 ) ,均有效 ;狭窄段 >2 .0cm的 12例 ,平均治疗 2 .6次 (2～ 4次 ) ,6例有效 (3例结合扩张 ) ,6例无效。化学烧伤后狭窄 3例 ,平均治疗 3次 (2～ 4次 ) ,均有效 (1例结合扩张 )。所有治疗均无并发症。结论　钬激光治疗食管狭窄安全有效。影响治疗效果的因素有首次治疗时管腔阻塞程度及浸润长度 ;瘢痕狭窄的长度 ;能量Objective To study the efficacy of Ho:YAG laser on esophagostenosis caused by carcinoma and scar retrospectively,and its factors influencing the efficacy.Methods 99 cases with esophagostenosis were treated with Ho:YAG laser for 230 irradiations altogether.Among them,36 cases were carcinous stenosis and 63 cases were scar stenosis.Results 20 cases who could pass the endoscopy were radiated with Ho:YAG laser averagely 1.8 times(1～4 time);17 cases were effective,3 invalid.16 cases who couldn't pass the endoscopy were averagely treated with Ho:YAG laser 3.7 times(2～6 times);8 cases were effective( 3 caser associated with dilator),another 8 cases ineffective.Among the patients with scar stenosis by surgery,32 cases(stenosis 1.0 cm)treated by Ho;YAG laser mean 1.1 times all were effective;16 cases with stenosis 1.0～2.0 cm treated with laser average 1.8 times(1～3 times) were also effective.12 cases with stenosis over 2.0 cm were treated with laser mean 2.6 times(2～4 times);6 cases(3 cases associated with dilator)were effective,other 6 cases invalid.3 cases of stenosis caused by chemical burn radiated by laser mean 3 times all were effective.No complications happened in these patients. Conclusion The study shows that the Ho:YAG laser irradiation is an effective therapy for esophagostenosis patients.The factors influencing the efficacy are possibly the lumin diameter,lesion length and irradiation modality etc.

关 键 词：食管狭窄 癌性狭窄 产痕性狭窄 内镜 疗效 钬激光 治疗 

分 类 号：R571.1[医药卫生—消化系统]