可取出食管支架植入术和内镜下探条扩张术治疗难治性食管狭窄的临床效果

Clinical effect of removable esophageal stent implantation and endoscopic probe dilatation in the treatment of refractory esophageal stricture

目的探究可取出食管支架植入术和内镜下探条扩张术治疗难治性食管狭窄的效果。方法选取2013年1月至2017年12月我院收治的63例难治性食管狭窄患者为研究对象,所用术式为可取出食管支架植入术(支架组,41例)或内镜下探条扩张术(探条组,22例)。比较两组狭窄扩张效果及并发症发生情况。结果治疗后及治疗后1、4个月,两组狭窄直径及Stooler分级均较治疗前明显改善(P<0.01);治疗后4个月,支架组的狭窄直径及Stooler分级均优于探条组(P<0.01);探条组治疗后4个月的狭窄直径劣于治疗后(P<0.01)。治疗后4个月,支架组疼痛及再发狭窄发生率显著低于探条组(P<0.05);支架组出血、移位发生率高于探条组(P<0.05);两组均未发生穿孔以及嵌顿。结论可取出食管支架植入术与内镜下探条扩张术术后并发症发生率无明显差异,但相比于内镜下探条扩张术,可取出食管支架植入术长期Stooler分级及狭窄改善更好。

Objective To evaluate the effects of removable esophageal stent implantation and endoscopic dilatation in the treatment of refractory esophageal stricture. Methods Sixty-three patients with refractory esophageal stricture in our hospital from January 2013 to December 2017 were selected as the study objects, the surgical methods were removable esophageal stent implantation(stent group, 41 cases) or endoscopic probe dilatation(probe group, 22 cases). The expansion effect of stenosis and the occurrence of complications were compared between the two groups. Results The stenosis diameter and Stooler classification of the two groups significantly improved after treatment and 1 and 4 months after treatment(P<0.01). Four months after treatment, the stenosis diameter and Stooler classification of the stent group were better than those of the probe group(P<0.01). In the probe group, the stenosis diameter at 4 months after treatment was worse than that after treatment(P<0.01). Four months after treatment, the incidences of pain and restenosis in the stent group were significantly lower than those in the probe group(P<0.05). The incidences of bleeding and displacement in the stent group were higher than those in the probe group(P<0.05). No perforation or incarceration occurred in both groups.Conclusion There are no significant difference in the incidences of postoperative complications between esophageal stent implantation and endoscopic probe dilatation, but compared with endoscopic probe dilatation, esophageal stent implantation showes better long-term Stooler grading and stenosis improvement.