内镜下环周切开术治疗食管癌术后吻合口狭窄的效果观察  

Curative effect of endoscopic circumferential incision on anastomotic stenosis after resection of esophageal cancer

作　　者：陈关领 张刚 董士海 Chen Guanling;Zhang Gang;Dong Shihai(Department of Gastroenterology,Xinyang People’s Hospital,Xinyang 464000,China)

机构地区：[1]信阳市人民医院消化内科,信阳464000

出　　处：《中国实用医刊》2022年第12期18-21,共4页Chinese Journal of Practical Medicine

摘　　要：目的探讨内镜下环周切开术治疗食管癌术后吻合口狭窄的临床疗效。方法回顾性分析信阳市人民医院2018年8月至2020年10月诊治的60例食管癌术后吻合口狭窄患者的临床资料,根据患者手术方式分为研究组(31例)和对照组(29例)。研究组给予内镜下环周切开术治疗,对照组给予内镜下探条扩张术治疗。比较两组患者手术前后吞咽困难程度、应激水平[C反应蛋白(CRP)、白细胞介素-6(IL-6)、皮质醇(Cor)],并统计术后并发症发生情况。结果两组患者术前吞咽困难程度比较差异未见统计学意义(P>0.05);术后,两组吞咽困难程度均降低,且研究组低于对照组(P<0.05)。术前以及术后12 h,两组CRP、IL-6、Cor水平比较差异均未见统计学意义(P均>0.05)。术后72 h,研究组CRP、IL-6、Cor水平均低于对照组(P均<0.05)。研究组术后并发症发生率(6.45%,2/31)与对照组(13.79%,4/29)比较差异未见统计学意义(P>0.05)。结论相比于内镜下探条扩张术,环周切开术治疗食管癌术后吻合口狭窄对于吞咽困难的改善效果更好,同时可减轻术后应激反应。Objective To investigate the curative effect of endoscopic circumferential incision on anastomotic stenosis after resection of esophageal cancer.Methods The clinical data of 60 patients with postoperative anastomotic stenosis of esophageal cancer who were diagnosed and treated in Xinyang People’s Hospital from August 2018 to October 2020 were retrospectively analyzed.According to operation methods,the patients were divided into study group(31 cases)and control group(29 cases).The study group was treated by endoscopic circumcision incision,and the control group was treated by endoscopic probe dilatation.The degree of dysphagia,stress response levels assessed by C-reactive protein(CRP),interleukin-6(IL-6)and cortisol(Cor)were compared between the two groups before and after operation.And postoperative complications of the two groups were counted.Results There was no significant difference in the degree of dysphagia between the two groups before operation(P>0.05);after operation,the degree of dysphagia decreased in both groups,and the study group had lower degree of dysphagia,compared with the control group(P<0.05).There was no significant difference in the levels of CRP,IL-6 and Cor between the two groups before operation and 12 hours after operation(all P>0.05).But the levels of CRP,IL-6 and Cor in the study group were lower than those in the control group 72 hours after operation(all P<0.05).There was no significant difference in the incidence of postoperative complications between the study group(6.45%,2/31)and the control group(13.79%,4/29),P>0.05.Conclusions Compared with endoscopic probe dilatation,endoscopic circumferential incision for anastomotic stenosis after resection of esophageal cancer had better effects on improving dysphagia.Meanwhile,it can alleviate postoperative stress response.

关 键 词：食管癌 内镜下环周切开术 吻合口狭窄 吞咽困难 

分 类 号：R735.1[医药卫生—肿瘤]