先天性食管狭窄4例报告及诊治经验分析  

Diagnosis and treatment of congenital esophageal stenosis:a report of 4 cases

作　　者：华凯云 赵勇 谷一超 廖俊敏 李爽爽 张雅楠[1] 杜京斌[1] 吴丹[1] 黄金狮 Hua Kaiyun;Zhao Yong;Gu Yichao;Liao Junmin;Li Shuangshuang;Zhang Yanan;Du Jingbin;Wu Dan;Huang Jinshi(Department of Neonatal Surgery,National Center of Children s Health,Beijing Children Hospital,Capital Medical University,Beijing 100045,China)

机构地区：[1]国家儿童医学中心(北京)首都医科大学附属北京儿童医院,北京市100045

出　　处：《临床小儿外科杂志》2020年第4期342-346,共5页Journal of Clinical Pediatric Surgery

摘　　要：目的探讨先天性食管狭窄的诊断及治疗方式。方法回顾性分析首都医科大学附属北京儿童医院2015年6月至2018年12月收治的4例先天性食管狭窄患儿的临床资料。4例患儿均为男性,入院年龄分别为5岁1个月、4岁2个月、10个月和3岁7个月。结果1例入院后诊断为贲门失迟缓症,在腹腔镜食管肌层切开过程中发现食管下段软骨异位,切除异位软骨后保留完整食管黏膜,随访1年进食顺利。1例先天性食管闭锁合并食管下段狭窄,多次影像学检查漏诊食管下段狭窄,胸腔镜下完成狭窄段切除再吻合,随访8个月进食顺利。1例球囊扩张食管4次,随访4个月进食顺利。1例先天性食管狭窄合并十二指肠梗阻,腹腔镜解除十二指肠梗阻7个月后行胸腔镜食管切除再吻合手术,随访2个月进食顺利。结论先天性食管狭窄常合并其它消化道畸形,容易漏诊,其治疗方式尚存在争议,腔镜手术具有较高可行性。Objective To explore the diagnosis and treatment of congenital esophageal stenosis(CES).Methods Retrospective analysis was conducted for the clinical data of 4 CES boys from June 2015 to December 2018.The ages of admission were 61,50,10 and 43 months respectively.Results Case 1 was diagnosed as achalasia cardia after admission.During laparoscopic esophageal myotomy,ectopic cartilage in lower esophagus was removed with intact esophageal mucosa.Case 2 had CES associated with esophageal atresia.Lower esophageal stenosis was missed for several times.And thoracoscopic stenosis resection and re-anastomosis were performed.Case 3 had stenosis of lower esophagus and balloon-dilate was performed for 4 times.Case 4 had CES with multiple duodenal obstructions and laparoscopy was performed for relieving the obstruction of duodenum.After 7 months,thoracoscopic esophagectomy and anastomosis were performed.Conclusion CES often has concomitant gastrointestinal malformations easily to be neglected.Treatment has remained controversial and endoscopy is both feasible and effective.

关 键 词：食管狭窄/先天性 食管狭窄/诊断 治疗 腹腔镜 胸腔镜 

分 类 号：R655.4[医药卫生—外科学] R726[医药卫生—临床医学]