上消化道内镜黏膜下剥离术后食管狭窄的原因及防治  

Causes and preventions of esophageal stenosis after endoscopic submucosal dissection of upper gastrointestinal tract

作　　者：曹世堂[1] 刘克祥[2] 杨立宇[3] 黄敏捷[4] 王玉华[5] 

机构地区：[1]白求恩国际和平医院二五六临床部消化内科 [2]白求恩国际和平医院二五六临床部神经内科 [3]白求恩国际和平医院二五六临床部医务处 [4]白求恩国际和平医院二五六临床部感染科,河北正定050800 [5]河北医科大学第四附属医院肿瘤内科,河北石家庄050081

出　　处：《现代仪器与医疗》2017年第5期48-50,共3页Modern Instruments & Medical Treatment

摘　　要：目的:分析上消化道内镜黏膜下剥离术(ESD)术后食管狭窄的原因,探讨防治对策。方法:整理行ESD术治疗,术后随访时间≥6个月的283例早期食管癌患者临床资料,按照其随访期间食管狭窄发生情况分为发生组、未发生组,计算术后食管狭窄发生率,总结影响患者ESD术后食管狭窄的影响因素,并使用Spearman等级相关分析,计算影响因素与食管狭窄程度的相关性。结果:283例患者中,共有33例术后发生食管狭窄,发生率为11.66%。Logistic多因素回归分析得出浸润深度m3为影响上消化道ESD术后食管狭窄的独立危险因素,病变环周范围<1/2为保护因素(P<0.05)。Spearman等级相关分析显示病变环周范围、病变浸润深度与食管狭窄程度均具有关联性(P<0.05)。结论:上消化道ESD术后食管狭窄与病变环周范围、浸润深度有关,早期识别高危因素并实施预防性球囊扩张有望降低术后食管狭窄风险。Objective：The objective of this study was to analyze the causes of esophageal stenosis after endoscopic submucosal dissection（ESD） of upper gastrointestinal tract and to explore the countermeasures of prevention and cure.Methods：The clinical data of 283 cases of early esophageal cancer patients who had had ESD treatment and whose postoperative follow-up time≥6 months were collected and the cases were divided into occurrence group and no occurrence group according to the occurrence of esophageal stenosis during follow-up period.The incidence rate of postoperative esophageal stenosis was calculated,and the influencing factors of esophageal stenosis after ESD surgery were summarized.The correlation between the influencing factors and the degree of esophageal stenosis was calculated by Spearman rank correlation analysis.Results：There were 33 cases of esophageal stenosis after ESD surgery in 283 patients,with an incidence rate of 11.66%.Logistic multivariate regression analysis showed that the depth of invasion,m3,was an independent risk factor of esophageal stenosis after ESD surgery of upper gastrointestinal tract,and the range of lesion cycle〈1/2 was a protective factor（P〈0.05）.Spearman rank correlation analysis showed that the range of lesion cycle,the depth of invasion and the degree of esophageal stenosis were related（P〈0.05）.Conclusions：The esophageal stenosis after ESD surgery of upper gastrointestinal tract is related to the range of lesion cycle and the depth of invasion.Early identification of high-risk factors and implementation of prophylactic balloon dilatation are expected to reduce the risk of postoperative esophageal stenosis.

关 键 词：上消化道肿瘤 内镜黏膜下剥离术 食管狭窄 防治 

分 类 号：R571[医药卫生—消化系统]