内镜下球囊扩张联合糖皮质激素治疗食管癌放疗后狭窄的疗效  

Efficacy of Endoscopic Balloon Dilatation Combined with Glucocorticoid in the Treatment of Esophageal Cancer Stenosis after Radiotherapy

作　　者：朱超莽 张群 殷红梅[1] 李多杰[1] ZHU Chao-mang;ZHANG Qun;YIN Hong-mei(First Affiliated Hospital of Bengbu Medical College,Anhui Province,233004)

机构地区：[1]蚌埠医学院第一附属医院肿瘤放疗科,安徽蚌埠233004

出　　处：《医学临床研究》2020年第12期1789-1792,共4页Journal of Clinical Research

基　　金：安徽省教育厅科研基金资助项目(No.KJ2015B075by)。

摘　　要：【目的】探讨内镜下球囊扩张联合应用激素治疗食管癌放疗后狭窄的疗效。【方法】本院收治的食管癌放疗后狭窄患者68例,随机分成两组,各34例。对照组采用内镜下球囊扩张治疗,观察组同时联合糖皮质激素治疗。比较两组疗效,并发症发生情况及治疗前、后的吞咽困难程度。比较两组白蛋白(ALB)、转铁蛋白(TF)、血红蛋白(Hb)、淋巴细胞计数(TCL)、体重水平及营养状态和免疫功能的变化。【结果】观察组经干预后,狭窄均得到改善,总有效率为100%,较对照组的94.12%无明显差异(P>0.05)。观察组治愈率为79.41%,显著高于对照组的55.88%(P<0.05)。两组并发症发生率比较差异无显著性(P>0.05)。在复查时,两组0级、1~2级占比明显高于治疗前(P<0.05)。且观察组0级占比显著高于,1~2级占比显著低于对照组(P<0.05)。两组干预后血清ALB、TF、Hb、TCL水平均高于治疗前,且观察组血清ALB、TF、TCL水平显著高于对照组(P<0.05)。两组复查时CD4+、CD4+/CD8+高于治疗前,CD8+低于治疗前(P<0.05),且观察组CD4+、CD4+/CD8+高于,CD8+低于对照组(P<0.05)。【结论】采用内镜下球囊扩张联合糖皮质激素对食管癌放疗后狭窄患者进行治疗,能提升狭窄治愈率,促进吞咽功能、营养状态、免疫功能进一步改善。【Objective】To investigate the effect of balloon dilatation combined with hormone in the treatment of esophageal cancer after radiotherapy.【Methods】A total of 68 patients with esophageal cancer stenosis after radiotherapy were randomly divided into two groups,34 cases in each group.The control group was treated with endoscopic balloon dilatation,while the observation group was treated with glucocorticoid.The curative effect,complications and dysphagia before and after treatment were compared between the two groups.Albumin(ALB),transferrin(TF),hemoglobin(Hb),lymphocyte count(TCL),body weight,nutritional status and immune function were compared between the two groups.【Results】After intervention,the stenosis in the observation group was improved,and the total effective rate was 100%,which had no significant difference compared with 94.12%of the control group(P>0.05).The cure rate of the observation group was 79.41%,which was significantly higher than 55.88%of the control group(P<0.05).There was no significant difference in the incidence of complications between the two groups(P>0.05).At the time of reexamination,the proportion of grade 0,grade 1-2 in the two groups was significantly higher than that before treatment(P<0.05).The proportion of grade 0 in the observation group was significantly higher than that in the control group(P<0.05).The levels of ALB,TF,Hb and TCL in the two groups after intervention were higher than those before treatment,and the levels of ALB,TF and TCL in the observation group were significantly higher than those in the control group(P<0.05).The levels of CD4+,CD4+/CD8+in the two groups were higher than those before treatment,and CD8+was lower than that before treatment(P<0.05),and the levels of CD4+,CD4+/CD8+and CD8+in the observation group were higher than those in the control group(P<0.05).【Conclusion】Endoscopic balloon dilatation combined with glucocorticoid in the treatment of esophageal cancer patients with stenosis after radiotherapy can improve the cure rate of stenosis

关 键 词：食管狭窄/外科学 食管狭窄/药物疗法 食管肿瘤/并发症 内窥镜检查 

分 类 号：R735.1[医药卫生—肿瘤]