食管良恶性狭窄的内镜下治疗(1)
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【摘要】 目的 探讨食管良恶性狭窄行内镜下综合治疗的临床疗效。方法 对2002年5月至2009年5月间248例食管良恶性狭窄患者分别或联合应用氩离子凝固术、球囊扩张及放置食管支架治疗,术后观察患者临床症状缓解情况。结果 本组良性狭窄96例,恶性狭窄152例。其中单用氩离子凝固术治疗者14例,显效10例(71.43%),有效3例(21.43%),无效1例(7.14%),总有效率92.86%;单纯球囊扩张15例,显效11例(73.33%),有效2例(13.33%),无效2例(13.33%),总有效率86.67%;氩离子凝固术联合食管支架置入术219例,均一次性放置成功。患者吞咽困难症状得到了不同程度的缓解,生活质量明显改善。结论 对于食管良恶性狭窄患者,根据不同性质选择不同内镜治下疗方法进行综合治疗,安全、有效、并发症少。
【关键词】食管狭窄;内窥镜检查;内窥镜介入治疗
Endoscopic therapy ofbenign and m alignant esophageal stenosis
XIE Yan-yan,LIU Ai-min,WU tao,et al.Department of gastroenterology,the Central Hospitalof Fuling,Chongqing 408000,China
【Abstract】 Objective To studythe clinical efficacyofbenign and m alignant esophageal stricture by endoscopic combined treatment.Methods From May 2002 to May 2009,248 cases of benign and m alignant
作者单位:408000重庆市涪陵中心医院消化内科
esophageal stenosis,either separately or combined with argon plasma coagulation,esophageal balloon dilatation and stent placement,clinical symptoms were observed after the situation.Results The group of 96 patients with benign stenosis,152 cases of m alignant stricture.One single-use argon plasma coagulation in 14 cases,effective 10 cases patient(71.43%),effective in 3 cases(21.43%),1 case(7.14%),total effective rate 92.86%.Simple balloon dilation in 15 cases were cured,effoctive11cases(73.33%),2 cases(13.33%),2 cases invalid(13.33%),total effective rate 86.67%.Argon plasma coagulation combined with 219 cases of esophageal stent were successfully placed a one-time.Patients with dysphagia have been varying degrees of ease and quality of life improved significantly.Conclusion For benign and m alignant esophageal stenosis,depending on the nature of choice of different methods of endoscopic treatment under the rule of comprehensive treatment,safe and effective with less complications.
【Key words】Esophageal stricture; Endoscopy; Endoscopic therapy
食管良恶性狭窄是消化系统较为常见的疾病,临床主要表现为不同程度吞咽困难,直接影响患者的生活质量。既往以手术为主,但手术创伤大、费用高,术后仍有复发转移及再次出现狭窄可能。近年来,随着内镜治疗技术的提高和内镜治疗器械的发展,内镜治疗已广泛用于临床。我们2002年5月至2009年5月间对248例食管良恶性狭窄患者分别或联合应用氩离子凝固术、球囊扩张及放置食管支架治疗,疗效满意,现报告如下。
1 资料与方法
1.1 一般资料 本组248例中男167例,女81例;年龄22~79岁,平均49岁。狭窄病因:良性狭窄96例,其中食管癌术后单纯狭窄82例,腐蚀性食管炎瘢痕形成8例,贲门失弛缓症6例;恶性狭窄152例,其中晚期食管癌131例,食管癌、贲门癌术后复发21例。食管病变长度2~12 cm ......
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