胃镜辅助下探条扩张术治疗先天性食道闭锁术后食道狭窄的效果及对炎症因子影响  

Effect of gastroscope-assisted Bougie Dilatation for Treatment of esophageal Stricture after congenital esophageal Atresia and its Influence on inflammatory Factors

作　　者：祁英文 李凡 王翠翠[1] 王勇[1] 顾琦[1] 王有亮[1] QI Yingwen;LI Fan;WANG Cuicui;WANG Yong;GU Qi;WANG Youliang(Pediatric Surgery,Gansu Maternal and Child Health Hospital,Lanzhou Gansu 730050,China)

机构地区：[1]甘肃省妇幼保健院小儿外科,甘肃兰州730050

出　　处：《临床研究》2020年第12期31-33,共3页Clinical Research

摘　　要：目的探究在胃镜辅助下通过探条扩张术治疗先天性食道闭锁术后出现食道狭窄的患儿效果及对炎症因子影响。方法选取2018年1月至2020年1月本院收治的先天性食道闭锁术后食道狭窄患儿90例作为研究对象,根据患儿首次扩张的月龄分为A组(月龄<4个月)45例和B组(月龄>4个月)45例,观察两组患儿的一般情况、治疗后食道狭窄扩张有效情况、两组治疗有效情况、两组术后并发症发生情况以及吻合口复发情况,观察治疗前后两组患儿血清C反应蛋白(CRP)、白细胞介素-6(IL-6)炎症指标水平。结果两组的性别对比无显著性差异(P>0.05)。两组的平均体重、狭窄指数和狭窄段直径对比有显著性差异(P<0.05)。治疗后,B组患儿的平均扩张次数(4.52±0.76)次比A组(3.32±0.68)次高,两组对比有显著性差异(P<0.05)。本研究中两组的术后扩张有效率及术后治疗有效率均为100%,两组的吻合口狭窄复发率及术后并发症发生率均为0.00%。治疗前3 d,两组患儿CRP和IL-6炎症指标水平对比无显著性差异(P>0.05)。治疗1个月后,两组患儿的CRP和IL-6炎症指标水平均低于治疗前(P<0.05),且两组患儿CRP和IL-6炎症指标水平对比无显著性差异(P>0.05)。结论对不同月龄的先天性食道闭锁患儿采用胃镜辅助下探条扩张术治疗,均可改善患儿的炎症反应水平,治疗效果相当,在不同月龄患儿中的应用价值均较高。Objective To explore the effect of gastroscope-assisted bougie dilatation for treatment of esophageal stricture after congenital esophageal atresia and its Influence on inflammatory Factors.Methods From January 2018 to January 2020,90 children with esophageal stricture after congenital esophageal atresia were selected as study subjects,according to the age of first dilation,45 cases were divided into group A(<4 months)and group B(>4 months),the general condition,the effective condition of Esophageal stricture and dilatation,the effective condition of the two groups,the postoperative complications and the recurrence of Anastomotic stoma,the serum levels of C reactive protein(CRP)and IL6(IL-6)were observed before and after treatment.Results There was no significant difference in sex of the two groups(P>0.05).There were significant differences in mean body weight,stenosis index and stenosis diameter between the two groups(P<0.05).After treatment,the average number of dilations in group B was(4.52±0.76)times higher than that in group A(3.32±0.68)times,there was significant difference between the two groups(P<0.05).In this study,the effective rate of dilatation and treatment was 100%in both groups,and the recurrent rate of anastomotic stenosis and postoperative complications were 0.00%in both groups.At the 3rd day before treatment,there was no significant difference between the two groups in the levels of CRP and IL-6(P>0.05).After 1 month of treatment,the levels of CRP and IL-6 in the two groups were lower than those before treatment(P<0.05),and there was no significant difference between the two groups(P>0.05).Conclusion Gastroscope-assisted bar dilatation can improve the level of inflammatory reaction in children with congenital esophageal atresia at different months of age.The therapeutic effect is equivalent and the applied value is higher in children of different months.

关 键 词：胃镜辅助 探条扩张术 先天性食道闭锁术 食道狭窄 炎症因子 

分 类 号：R726.5[医药卫生—儿科]