地塞米松注射联合扩张对早期食管癌ESD后狭窄的评价

Efficacy of dexamethasone injection in combination with bougie dilatation on the treatment of post-ESD stenosis in patients with early esophageal cancer

目的探讨黏膜下注射地塞米松联合探条扩张治疗早期食管癌内镜黏膜下剥离术(ESD)后狭窄的疗效。方法对45例早期食管癌ESD术后狭窄患者分组研究,试验组行探条扩张联合地塞米松黏膜下注射,对照组仅进行探条扩张治疗,观察比较两组治疗后再次发生狭窄的时间。结果试验组术后首次再发吞咽困难(Stooler评分1级)的中位时间为49.00 d,对照组为28.00 d,差异有统计学意义(P<0.05);出现Stooler评分3级的中位时间,试验组为64.00 d,对照组为39.00 d,差异有统计学意义(P<0.05)。结论黏膜下注射地塞米松注射联合探条扩张对早期食管癌ESD后狭窄治疗是安全有效的,能延缓再发狭窄的时间。

Objective To explore the efficacy of submembranous injection of dexamethasone in combination with bougie dilatation on the treatment of post-ESD stenosis in patients with early esophageal cancer.Methods A total of 45 patients with early esophageal cancer and post-ESD stenosis were divided into two groups.The experimental group was treated with bougie dilatation and submembranous injection of dexamethasone,and the control group with bougie dilatation only.The time before reoccurrence of stenosis after the treatment was compared.Results The mean time before the reoccurrence of dysphagia（rated Grade 1 by Stooler＇s score） for the experimental group was 49.00 d and that for the control group was 28.00 d,with the difference between the time showing statistical significance（P〈0.05）; the mean time before the reoccurrence of Grade 3 dysphagia rated by Stooler＇s score for the experimental group was 64.00 d and that for the control group was 39.00 d,with the difference between the time showing statistical significance,too（P〈0.05）.Conclusion The submembranous injection of dexamethasone in combination with bougie dilatation is safe and effective on the treatment of post-ESD stenosis in patients with early esophageal cancer and can delay the time of the recurrence of stenosis.