小儿食管良性狭窄内镜下扩张治疗的效果分析

Therapeutic effect of endoscope-guided bougie dilatation on benign esophageal stricture in children

目的评价内镜下扩张治疗小儿食管良性狭窄的疗效。方法71例小儿食管良性狭窄纳入回顾性分析，按狭窄病因分成3组，分别为反流性食管狭窄（A组，n=8）、先天性食管闭锁术后狭窄（B组，n=30）和化学性烧伤性食管狭窄（c组，n=33），统计总体有效率并对组间治疗情况进行对比分析。结果71例患儿共计扩张885次，总体有效率达94．37％（67／71），且3组间治疗有效率差异无统计学意义（P〉O．05）。C组平均扩张次数（14．9次／例）明显多于A组（9．1次／例，P〈O．05）和B组（10．7次／例，P〈O．05），并发症发生率亦明显高于A组（1．22％比0，P〈O．05）和B组（1．22％比0．31％，P〈O．05）。结论内镜下扩张治疗小儿食管良性狭窄总体疗效较好，但化学性烧伤性食管狭窄所需的扩张次数较多，且并发症发生率较高，属于难治性小儿食管良性狭窄。

Objective To investigate therapeutic effect of endoscope-guided bougie dilatation on children with benign esophageal stricture. Methods Data of 71 patients with benign esophageal stricture were retrospective analyzed.Patients were divided into group A （reflux stricture）, B （congenital esophageal atresia stricture） and C （caustic injuries stricture）, based on different causes. The expansion effectiveness and＇ factors of the three groups were analyzed. Results A total of 885 expansions were performed on 71 patients with the total efficacy rate 94. 37% （67/71）. No statistic differences were shown in expansion effectiveness among the 3 groups; group C （14.9 times/case, P 〈 0.05 ）showed more expansion frequencies than group A （9. 1 times/case,P〈0. 05）and group B （ 10. 7 times/case, P〈0. 05）, more complications than group A （ 1.22% VS 0,P〈0. 05） and group B（ 1.22% VS 0. 31% ,P〈0. 05）. Conclusion Endoscope-guided bougie dilatation is safe and effective for childrens＇ benign esophageal stricture. Caustic injuries, refractory benign esophageal stricture.need more expansions and may be accompanied with more complications.