球囊扩张治疗小儿上胃肠道狭窄

Application of Pneumatic Dilation Method in Treating Infant Duodenum Anastomotic Stoma Stenosis

目的:探讨球囊扩张成形术在小儿上胃肠道狭窄中的应用价值。方法:回顾性分析9例小儿上胃肠道狭窄球囊扩张治疗前后的胃肠造影表现。其中,先天性食管下段狭窄4例,贲门失弛缓症3例,强碱食管腐蚀伤后狭窄1例,十二指肠隔膜状狭窄术后吻合口狭窄1例。7例行两次球囊扩张,1例行三次球囊扩张,1例行一次球囊扩张。扩张前均行上消化道钡餐或碘油造影检查,明确病灶部位及狭窄程度后分别使用8mm×40mm^20mm×40mm球囊进行扩张;扩张后复查上消化道造影进行对照分析。结果:6例患儿扩张前狭窄段直径约0.3~0.5cm,扩张后达1.4~2.0cm;2例经球囊扩张后狭窄段直径达0.8~1.0cm,梗阻症状明显改善,后转手术治疗;1例行一次扩张后自动出院,治疗效果不详。结论:球囊扩张成形术创伤小,操作简便,效果良好,是治疗小儿上胃肠道狭窄的首选方法。

Objective：To investigate the application value of pneumatic dilation method in infant gastroenteric stricture treatment. Methods： Pneumatic dilation treatment in 9 cases with gastroenteric stricture were analyzed, which included lower segment esophageal stenosis （n= 4）, Achalasia （n： 3）, strong alkali corrosive esophageal burn （n= 1 ） and anastomotic stoma after operation of duodenal diaphragm （n= 1）. Most of the patients obtained the dilation treatment twice. The pneumatic dilation method was used for all patients. The position of focus and degree of stenosis must be made clear before commencing this treatment,and then 8mm×40mm～20mm×40mm type balloons were used respectively. Results： 8 cases were perfectly recovered by this treatment and 1 case failed. Conclusion： Pneumatic dilation is the method of first choice in the treatment of stricture of upper gastrointestinal tract.