内镜下萨氏扩张器扩张联合局部注射曲安奈德治疗食管良性吻合口狭窄的疗效及安全性研究

Endoscopic Dilatation with Sarschner Dilator Combined with Local Injection of Triamcinolone Acetonide in the Treatment of Benign Esophageal Anastomotic Stricture

目的:探讨食管良性吻合口狭窄经内镜下萨氏扩张器扩张联合局部注射曲安奈德治疗的临床疗效及安全性。方法:选取79例食管良性吻合口狭窄患者作为研究对象,根据数字表法将其随机分为对照组(n=38)和研究组(n=41),对照组给予内镜下萨氏扩张器扩张治疗,研究组在对照组基础上联合局部注射曲安奈德治疗,比较两组患者临床疗效、术后恢复情况以及安全性。结果:研究组治疗后总有效率为85.37%(35/41),高于对照组患者的65.79%(25/38)(x^2=4.138,P=0.002)。研究组持续症状缓解时间、再次进行内镜下扩张治疗的间隔时间均长于对照组(t=21.573、27.209,P=0.000、0.000),两组患者治疗前Stooler评分比较差异无统计学意义(t=0.266,P=0.791),两组患者治疗后Stooler评分均降低(t=16.606、25.962,P=0.000、0.000),且研究组低于对照组(t=7.407,P=0.000)。研究组术后并发症总发生率为19.51%(8/41),低于对照组患者的42.11%(16/38)(x^2=4.760,P=0.009)。结论:食管良性吻合口狭窄经内镜下萨氏扩张器扩张联合局部注射曲安奈德治疗后,可获得较好的疗效,患者临床症状得到改善,同时还可减少并发症发生率,临床应用价值较高。

Objective: To investigate the clinical efficacy and safety of endoscopic dilatation with Sarschner dilator combined with local injection of triamcinolone acetonide in the treatment of benign esophageal anastomotic stricture. Methods: 79 patients with benign esophageal anastomotic stenosis were selected as the research subjects. They were divided into control group(n=38) and study group(n=41) according to the digital table method. The control group was treated with endoscopic dilatation with Sarschner dilator. The study group was treated with triamcinolone acetonide on the basis of the control group. The clinical efficacy, postoperative recovery and safety of the two groups were compared. Results: The total effective rate in the study group was 85.37%(35/41), which was higher than 65.79%(25/38) in the control group( x^2=4.138, P=0.002). The duration of symptoms relief and the interval between the second endoscopic dilatation in the study group were longer than those in the control group(t=21.573, 27.209;P=0.000, 0.000). There was no significant difference in Stooler score between the two groups before treatment(t=0.266, P=0.791). The Stooler scores of both groups decreased after treatment(t=16.606, 25.962;P=0.000, 0.000), and the study group was lower than the control group(t=7.407, P=0.000). The total incidence of postoperative complications was 19.51%(8/41) in the study group, which was lower than 42.11%(16/38) in the control group(x^2=4.760, P=0.009). Conclusion: Benign esophageal anastomotic stricture can be treated by endoscopic dilatation with Sarschner dilator combined with local injection of triamcinolone acetonide. The clinical symptoms of the patients can be improved, and the incidence of complications can be reduced. The clinical application value is high.