无痛胃镜下探条或水囊扩张术治疗食管贲门狭窄的安全性和有效性

Efficiency and Safety of Water Balloon Dilator or Bougienage by Painless Gastroscopy for Treatment of Esophageal and Cardiac Stricture

目的探讨无痛胃镜下探条或水囊扩张术治疗食管贲门狭窄的安全性及有效性,为临床治疗提供参考依据.方法选取60例食管贲门狭窄患者作为研究对象,根据随机数字表法分为两组(n=30),探条组给予无痛胃镜探条扩张术治疗,水囊组给予无痛胃镜水囊扩张术治疗.比较两组患者的临床疗效、扩张次数以及并发症发生率.随访6个月,比较两组患者再度狭窄发生率.结果两组患者总有效率(96.67%,90.00%)比较差异无统计学意义(P>0.05);水囊组治愈率明显高于探条组(86.67%,63.35%),差异具有统计学意义(P<0.05);水囊组1次扩张率明显高于探条组(66.67%,36.67%),平均扩张次数明显低于探条组((1.62±0.54)次,(3.47±1.03)次),差异均具有统计学意义(P<0.05);水囊组并发症发生率明显低于探条组(16.67%,40.00%),差异具有统计学意义(P<0.05);随访6个月,两组患者再度狭窄发生率(10.00%,16.67%)比较差异无统计学意义(P>0.05).结论无痛胃镜下水囊扩张术治疗食管贲门狭窄的疗效明显优于探条扩张术,且减少了扩张次数及并发症的发生.

Objective To investigate the efficiency and safety of water balloon dilator or bougienage by painless gastroscopy for treatment of stricture of esophagus and cardia,and to provide reference for clinical treatments.Method A total of 60 patients with stenosis of esophagus and cardia were selected as the investigated subject,and the patients were divided into two groups according to the random number table(n=30).The bouginage group received painless gastroscopy bouginage treatment,and the water balloon dilator group received painless gastroscopy water balloon dilator treatment.The clinical efficacy,the incidence of complications and the expansion times were compared between the two groups.The patients were followed up for 6 months,and the incidence of restenosis was compared between the two groups.Results There was no significant difference in the total effective rate(96.67%vs 90.00%)between the two groups(P>0.0 5).The cure rate of the water balloon dilator group was significantly higher than that of the bouginage group(86.67%vs 63.35%)(P<0.05).The once expansion rate of water balloon dilator group was significantly higher than that of the bouginage group(66.6 7%vs 36.67%),and the average time of expansion was significantly lower than that of the bouginage group((1.62±0.54)vs(3.47±1.03))(P<0.05).The complication rate of the water balloon dilator group was lower than that of the bouginage group(16.67%vs 40.0 0%)(P<0.05).The patients were followed up for 6 months,and there was no significant difference in the incidence of restenosis(10.00%vs 16.67%)between the two groups(P>0.05).Conclusion The effect of painless gastroscopy water balloon dilator for the treatment of esophageal stenosis was significantly better than the bouginage,which can reduce the expansion times,the incidence of complications,and thus is worthy of clinical attention.