内镜下纵行切开联合曲安奈德注射治疗化学烧伤性食管狭窄的特征分析及效果评价  

Characteristic analysis and effect evaluation of endoscopic longitudinal incision combined with triamcinolone injection in the treatment of caustic esophageal stenosis

作　　者：陈虹羽[1,2] 徐梦楠 张静 郭瑞 陈晓 李曼华 张小朋 银新 李白容 孙涛 范崇熙 宁守斌 CHEN Hongyu;XU Mengnan;ZHANG Jing;GUO Rui;CHEN Xiao;LI Manhua;ZHANG Xiaopeng;YIN Xin;LI Bairong;SUN Tao;FAN Chongxi;NING Shoubin(Department of Gastroenterology,Air Force Clinical College,Anhui Medical University;Department of Gastroenterology,Air Force Medical Center,Beijing 100142,China)

机构地区：[1]安徽医科大学空军临床学院消化内科 [2]空军特色医学中心消化内科,北京100142

出　　处：《空军军医大学学报》2024年第3期292-297,共6页Journal of Air Force Medical University

基　　金：北京市科技计划项目(Z221100007422061);空军军医大学临床研究项目(2021LC2201)。

摘　　要：目的探讨内镜下纵行切开联合曲安奈德注射治疗化学烧伤性食管狭窄的疗效及可行性。方法选取2019年2月至2023年2月在空军特色医学中心接受内镜下纵行切开联合曲安奈德注射治疗的15例化学烧伤性食管狭窄患者的临床资料进行回顾性观察。结果15例患者共接受内镜治疗59次,平均手术用时(31.73±11.36)min,切开狭窄长度(7.53±4.88)cm,治疗过程中有6例合并支架置入,末次治疗结束8周后吞咽困难情况及BMI明显改善,总有效率80%,且末次治疗后6个月60%(9/15)患者Stooler分级为0~1级。59次治疗过程中有3次出现肌层损伤或微小穿孔,均给予术中钛夹封闭,无其他内镜治疗相关严重并发症。结论内镜下纵行切开联合曲安奈德注射治疗化学烧伤性食管狭窄的短期内安全、有效,但其长期疗效仍有待随访观察。Objective To investigate the efficacy and feasibility of endoscopic longitudinal incision combined with triamcinolone injection in the treatment of caustic esophageal stenosis.Methods The clinical data of 15 patients with caustic esophageal stenosis who received endoscopic longitudinal incision combined with triamcinolone injection at Air Force Medical Center from February 2019 to February 2023 were retrospectively observed.Results The 15 patients received 59 times of endoscopic treatment,with an average operation time of(31.73±11.36)min and incision stenosis length of(7.53±4.88)cm.In the course of treatment,6 patients were combined with stent implantation.The dysphagia and BMI were significantly improved 8 weeks after the end of the last treatment,and the overall effective rate was 80%.Within 6 months after the last treatment,60%(9/15)of the patients had the Stooler score from 0 to 1.In the 59 treatments,muscle injury or minor perforation occurred in 3 times,all of which were closed with titanium clips,and there were no other serious complications related to endoscopic therapy.Conclusion Endoscopic longitudinal incision combined with triamcinolone injection is safe and effective in the short term for the treatment of caustic esophageal stenosis,but its long-term efficacy remains to be observed.

关 键 词：化学烧伤性食管狭窄 内镜下纵行切开 曲安奈德注射 Stooler分级 疗效评价 

分 类 号：R571[医药卫生—消化系统]