球囊扩张术在小儿食道狭窄及贲门失弛缓中的应用分析

发布时间：2018-05-31 02:33

本文选题：食管狭窄 + 气囊扩张术　；参考：《中国内镜杂志》2017年08期

【摘要】：目的比较球囊扩张术(EBD)治疗小儿食道狭窄及贲门失弛缓的疗效,分析预后影响因素。方法 2012年1月-2014年12月共28例患儿纳入研究。其中,食道狭窄22例,贲门失弛缓6例,利用扩张球囊进行治疗。结果 28例患儿共接受57次球囊扩张术,随访12~36个月,28例全部成功。其中,23例患儿症状完全缓解(82.14%),4例患儿部分缓解(14.28%),1例无效(3.57%),1例复发(3.57%)。治疗成功率、有效率、并发症发生率及复发率两组患儿比较差异无统计学意义。食道狭窄患儿中,多个狭窄患儿并发症较单个狭窄患儿多,狭窄直径越小并发症越多,比较差异有统计学意义(P0.05);治疗效果与狭窄直径和狭窄个数显著相关(P0.05)。贲门失弛缓组患儿中,发病年龄及明确诊断前症状持续的时间均对EBD治疗效果没有显著影响。结论 EBD是小儿食道狭窄及贲门失弛缓安全有效的治疗手段;狭窄直径和狭窄个数是影响食道狭窄治疗效果最重要的因素,而第一次球囊扩张与食道闭锁手术之间的时间则是术后食道狭窄患儿最重要的影响因素。
[Abstract]:Objective to compare the efficacy and prognostic factors of balloon dilatation (EBD) in the treatment of esophageal stenosis and achalasia in children. Methods from January 2012 to December 2014, 28 children were included in the study. 22 cases of esophageal stenosis and 6 cases of achalasia were treated with dilated balloon. Results there were 57 times of balloon dilatation in 28 cases, and 28 cases were successfully followed up for 12 ~ 36 months. Among them, 23 cases had complete remission (82.14%), 4 cases had partial remission (14.28%), 1 case had no effect (3.57%) and 1 case had recurrence (3.57%). There was no significant difference in treatment success rate, effective rate, complication rate and recurrence rate between the two groups. In the patients with esophageal stenosis, there were more complications in multiple stenosis children than in single stenosis children, and the smaller the stenosis diameter was, the more complications were. The difference was statistically significant (P 0.05), and the therapeutic effect was significantly correlated with the stenosis diameter and the number of stenosis. In the achalasia group, the age of onset and the duration of definite pre-diagnosis symptoms had no significant effect on the treatment effect of EBD. Conclusion EBD is a safe and effective method for the treatment of esophageal stenosis and achalasia in children and the diameter and number of stenosis are the most important factors affecting the therapeutic effect of esophageal stenosis. The time between the first balloon dilation and esophageal atresia was the most important factor.
【作者单位】：广东省深圳市儿童医院消化内科;
【分类号】：R725.7

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