黏膜下注射曲安奈德在食管顽固性良性狭窄扩张治疗后的应用价值

Effects of Submucous Injection of Triamcinolone Acetonide in Treatment of Refractory Benign Esophageal Stricture

目的探讨黏膜下注射曲安奈德在食管顽固性良性狭窄扩张治疗后的应用价值。方法选择经反复探条扩张治疗5次以上且扩张间隔时间少于15d的食管良性狭窄21例,内镜下扩张后进镜至病灶下缘,由下缘至上缘在多点多部位黏膜下注射曲安奈德,每周1次,4次为1个疗程,观察注药后患者症状缓解时间、平均扩张次数、扩张间隔时间、进食计分,并与注药前比较。结果与注药前比较,黏膜下注射曲安奈德后患者症状缓解时间、平均扩张次数、扩张间隔时间、进食计分差异均有统计学意义(P<0.05)。结论食管顽固性良性狭窄扩张治疗后行黏膜下注射曲安奈德,可有效减少扩张次数,延长再狭窄时间,改善吞咽困难症状,提高患者生活质量。

Objective To evaluate the efficacy of endoscopic submucosal injection of Triamcinolone acetonide in refractory benign esophageal stricture. Methods 21 patients with benign esophageal stricture who underwent dilation treatment for more than five times with an interval of less than 15d were selected. After dilation under endoscope the scope was expanded to the lower edge of the lesion, multi-point multi-site submucosal injection of Triamcinolone acetonide was administered from the lower edge to the upper edge once a week, four times in a course of treatment. The time of symptomatic relief, the frequency, the interval time of dilation and dysphagia score were observed and compared with that before treatment. Results The results showed that, the time of symptomatic relief, the frequency, the interval time of dilation and dysphagia score of patients injected with Triamcinolone acetonide were statistically different （P 〈 0. 05 ）. Conciusion The submucosal injection of Triamcinolone acetonide in refractory benign esophageal stricture is effective in reducing the dilation frequency, increasing restenosis time and improving dysphagia and quality of life.