球囊联合探条扩张术在食管癌放疗后食管狭窄中的应用

Application of balloon combined with probe dilatation in esophageal cancer stenosis after radiotherapy

目的探讨球囊联合探条扩张术对食管癌放疗后食管狭窄患者吞咽功能及血清转铁蛋白(TF)、清蛋白(ALB)的影响。方法收集2018年11月至2020年11月该院108例食管癌放疗后食管狭窄患者的临床资料进行回顾性分析,根据手术方案分为对照组和观察组,各54例。对照组行单纯探条扩张术,观察组行球囊联合探条扩张术。对比两组手术效果、吻合口狭窄直径、一次扩张率、扩张率、吞咽困难改善情况、并发症,比较手术前后营养状况(TF、ALB、体重)、摄食功能(FOIS)、生命质量(FACT-G)。结果术后3个月,观察组手术治疗总有效率高于对照组(P<0.05);观察组狭窄直径大于对照组,扩张次数少于对照组,一次性扩张治疗高于对照组(P<0.05);术后3个月观察组吞咽功能分级、FOIS评分及血清TF、ALB水平改善情况优于对照组(P<0.05);术后3个月两组生理状况、社会/家庭状况、情感状况、功能状况评分及体重高于术前(P<0.05);两组并发症发生率比较,差异无统计学意义(P>0.05)。结论球囊联合探条扩张术可上调食管癌放疗后食管狭窄患者血清TF、ALB水平,改善吞咽功能及摄食功能,提高手术效果。

Objective To investigate the effect of balloon combined with probe expansion on swallowing function,serum transferrin(TF)and albumin(ALB)in patients with esophageal cancer stenosis after radiotherapy.Methods The clinical data of 108 patients with esophageal cancer post-radiotherapy stenosis in our hospital from November 2018 to November 2020 were collected for retrospective analysis.According to the surgical plan,54 cases were divided into groups.The control group underwent simple probe expansion,and the observation group underwent balloon combined probe expansion.To observe and compare the surgical effects,anastomotic stenosis diameter,one-time expansion rate,expansion rate,improvement of dysphagia,and complications between the two groups,and compare the nutritional status(TF,ALB,weight),food intake function(FOIS),quality of life(FACT-G)before and after the operation.Results(1)At 3 months after operation,the total effective rate of surgical treatment in the observation group was higher than that in the control group(P<0.05);(2)The diameter of stenosis in the observation group was larger than that in the control group,and the number of dilations was less than that of the control group.Control group(P<0.05);(3)The improvement of swallowing function classification,FOIS score and serum TF and ALB levels in the observation group 3 months after operation was better than that of the control group(P<0.05);(4)3 months after operation The physiological status,social/family status,emotional status,functional status score and weight of the two groups were higher than those before operation(P<0.05);(5)There was no statistically significant difference in the incidence of complications between the two groups(P>0.05).Conclusion Balloon combined with probe dilatation can increase the serum TF and ALB levels in patients with esophageal cancer stenosis after radiotherapy,improve swallowing function and feeding function,and improve the effect of surgery.