静脉麻醉下行内镜下探条扩张术治疗食管狭窄的疗效分析

Efficacy Analysis of Esophageal Stenosis Treated by Endoscopic Dilation under Intravenous Anesthesia

目的静脉麻醉下内镜下探条扩张术治疗食管狭窄的疗效及安全性分析。方法回顾性分析四川省肿瘤医院5年491例食管狭窄患者的静脉麻醉下内镜下探条扩张术的病例资料,其中食管、贲门癌术后吻合口狭窄483例,食管癌放疗后狭窄8例。结果静脉麻醉后,扩张前心率:(80.26±11.39)次/min、血氧饱和度(98.2±1.40)%;扩张后心率:(77.08±10.23)次/min、血氧饱和度(92.1±2.5)%。扩张成功率99.8%,随访1个月后有效率为92.3%,随访3个月后有效率为81.3%。重度并发症发生率0.1%,无严重麻醉并发症发生。结论静脉麻醉下行探条食管扩张术治疗食管狭窄是安全有效的方法 ,在操作过程中应严密监测患者生命体征,对有严重心肺功能不全、心律失常、心动过缓、基础血压较低的患者应慎用。

Objective To analyze curative effect and the safety of endoscopic exploration dilation on esophageal stricture with intravenous anesthesia.Methods491cases of esophageal stricture with intravenous anesthesia treated by endoscopic exploration dilation in the recent5years in Sichuan Cancer Hospital were reviewed and analyzed.Among them,483cases were anastomotic stricture of esophagus and cardia cancer,8cases were stricture of esophageal cancer after radiotherapy.Results The success rate of dilation reached to99.8%,the efficiency rate reached to92.3%in the first month,and then reached to81.3%in the coming3months.The incidence of severe complications was0.2%,and no serious anesthesia complication happened.Conclusion Vaginal esophageal dilatation of esophageal dilation is a safe and effective method for esophageal stenosis.Vital signs should be closely monitored during operation.For patients with severe cardiopulmonary insufficiency,arrhythmia,bradycardia and low baseline blood pressure it should be cautious used.