口服醋酸泼尼松对早期食管癌术后食管狭窄的预防效果及安全性分析

Preventing effects and safety analysis of oral prednisone acetate on esophageal stenosis after early esophageal cancer surgery

目的探讨口服醋酸泼尼松对早期食管癌及癌前病变内镜黏膜下剥离术(endoscopic submucosal dissection,ESD)后食管狭窄预防的临床效果及安全性。方法选取四川省绵阳市中心医院2016年12月至2017年12月收治的早期食管癌及癌前病变ESD术后患者108例,采用随机数字表法将其分为常规组和预防组各54例。常规组予以患者常规术后治疗,预防组在此基础上,予以患者口服醋酸泼尼松。比较两组患者狭窄发生率、扩张次数及安全性。结果治疗后,常规组患者狭窄发生率为61.11%(33/54),预防组患者狭窄发生率为29.62%(16/54),预防组患者狭窄发生率显著低于常规组,差异有显著性(P<0.05)。常规组患者扩张次数为(9.68±4.77)次,预防组患者扩张次数为(3.75±2.54)次,预防组患者扩张次数显著低于常规组,差异有显著性(P<0.05)。两组患者均未出现原位癌复发情况及手术相关性死亡,预防组患者未出现激素使用不良反应事件。结论口服醋酸泼尼松能够有效预防食管早期癌及癌前病变ESD术后食管狭窄发生,同时安全性较高,值得在临床应用。

Objective To explore the preventing effects and safety of oral prednisone acetate in the prevention of esophageal stricture after endoscopic submucosal dissection(ESD)in early esophageal cancer and precancerous lesions.Method 108 patients with early esophageal cancer and precancerous lesions who underwent ESD from December 2016 to December 2017 were enrolled in the study.They were randomly divided into routine group and prevention group,each of 54 cases.The routine group was treated with routine postoperative treatment.On the basis of that,the prevention group was given oral prednisone acetate.The incidence of stenosis,the number of expansions,and safety were compared between the two groups.Result After treatment,the incidence of stenosis was 61.11%(33/54)in the routine group,29.62%(16/54)in the prevention group,and the stenosis rate was significantly lower in the prevention group than in the conventional group.Academic significance(P<0.05).The number of patients in the conventional group was(9.68±4.77),and the number of expansion in the prevention group was(3.75±2.54).The number of expansion in the prevention group was significantly lower than that in the conventional group(P<0.05).There were no recurrences of carcinoma in situ and surgical-related deaths in the two groups.No adverse reactions to hornone use were observed in the prevention group.Conclusion Oral prednisone acetate can effectively prevent esophageal stenosis after ESD in early esophageal cancer and precancerous lesions,and it is safe and worthy of clinical promotion.