泼尼松联合局部注射曲安奈德对早期食管癌ESD术后食管狭窄的疗效和安全性研究  

Efficacy and Safety of Prednisone Combined with Local Injection of Triamcinolone Acetonide in Preventing Esophageal Stricture After ESD for Early Esophageal Cancer

作　　者：靳芳莉 赵治国 曹智博 钤培国 JIN Fangli;ZHAO Zhiguo;CAO Zhibo(Henan Hospital of TCM,Zhengzhou,450000)

机构地区：[1]河南省中医院,河南省中医药大学第二附属医院,450000 [2]郑州颐和医院,450000

出　　处：《实用癌症杂志》2023年第7期1132-1135,共4页The Practical Journal of Cancer

摘　　要：目的研究泼尼松联合局部注射曲安奈德预防早期食管癌内镜黏膜下剥离术(ESD)术后食管狭窄的疗效和安全性。方法回顾性分析76例行ESD治疗的早期食管癌且术后发生食管狭窄的患者,分为对照组与研究组,各38例。两组术后均常规治疗,对照组局部注射曲安奈德,研究组在注射曲安奈德基础上联合泼尼松治疗。比较两组Stooler分级评分,疗效,扩张情况及并发症发生率。结果研究组首次扩张距ESD时间长于对照组,扩张次数少于对照组(P<0.05);扩张治疗前两组吞咽Stooler分级评分无统计学意义(P>0.05),治疗后研究组评分低于对照组(P<0.05);扩张治疗后,对照组显效11例、有效16例、无效11例,研究组分别为23例、12例、3例,研究组有效率(92.11%)高于对照组(71.05%)(P<0.05);对照组3例出血、3例穿孔,研究组分别为1例、0例,研究组并发症发生率(2.63%)低于对照组(15.79%)(P<0.05)。结论泼尼松联合局部注射曲安奈德能有效延长早期食管癌ESD术后吞咽困难出现时间,减少术后扩张次数,有效改善术后食管狭窄患者吞咽功能,并发症更少,可作为早期食管癌ESD术后预防和治疗食管狭窄的有效方法。Objective To study the efficacy and safety of prednisone combined with local injection of triamcinolone acetonide in the prevention of esophageal stricture after endoscopic submucosal dissection(ESD)for early esophageal cancer.Methods 76 early esophageal cancer patients with postoperative esophageal stricture after ESD surgery were retrospectively analyzed,and randomly assigned into 2 groups,each with 38 cases each.Both groups received routine treatment after operation,based on this,the control group received local injection of triamcinolone acetonide,while the study group received prednisone combined with local injection of triamcinolone acetonide.Then the Stooler dysphagia grading score,clinical efficacy,post-stenosis dilations and complication rate were compared between the two groups.Results The study group had longer time intervals of the first dilation after ESD and smaller number of dilations compared to the control group,with statistical difference(P<0.05).The Stooler dysphagia grading score yielded no statistical difference between the 2 groups before dilation(P>0.05),while the study group scored lower on Stooler's scale than the control group after treatment(P<0.05).In the control group,11 cases were significantly effective,16 cases were effective and 11 cases were ineffective.In the study group,23 cases were significantly effective,12 cases were effective and 3 cases were ineffective.The overall efficacy rate was 92.11%in the study group,which was higher than 71.05%in the control group(P<0.05).There were 3 cases of bleeding and 3 cases of perforation in the control group,and 1 case of bleeding and 0 case of perforation in the study group.The total complication rate was 2.63%in the study group,which was lower than 15.79%in the control group(P<0.05).Conclusion Application of prednisone combined with local injection of triamcinolone acetonide after ESD for early esophageal cancer can effectively prolong the time to the onset of dysphagia,reduce the number of postoperative dilatations,and thus can improve

关 键 词：早期食管癌 内镜黏膜下剥离术 泼尼松 曲安奈德 局部注射 疗效 安全性 

分 类 号：R735.1[医药卫生—肿瘤]