内窥镜直视下球囊扩张治疗对食管狭窄患者临床疗效及生活质量评分的影响

Effects of balloon dilatation treatment under erthyphoria with endoscopy on the clinical efficacy and QOL score of patients with esophageal stenosis

目的:探讨内窥镜直视下球囊扩张治疗对食管癌放射治疗后食管狭窄患者临床疗效及生活质量(QOL)评分的影响。方法:选取医院确诊并治疗的88例食管狭窄患者,采用随机数表法将其分为对照组和观察组,每组44例,所有患者均为食管癌放射治疗而导致的食管狭窄。分析所有患者的诊疗资料,依据不同治疗方式进行评估,对照组应用探条扩张,观察组应用球囊扩张。观察比较两组食管再狭窄发生率及间隔时间;两组的疗效指标、吞咽功能评级分布情况;两组治疗前后QOL评分水平差异及变化情况,以及并发症。结果:观察组食管再狭窄发生率为34.1%,对照组为56.8%,两组比较差异有统计学意义(x^(2)=6.152,P<0.05);观察组食管再狭窄发生间隔时间为(3.5±0.8)月,对照组为(1.9±0.7)月,两组比较差异有统计学意义(t=18.374,P<0.05);观察组治疗后吞咽功能评级中0级比率较对照组更高,两组比较差异有统计学意义(x^(2)=6.294,P<0.05);观察组治疗后躯体功能、情绪功能、社会功能以及呕吐恶心相关QOL评分水平较对照组更高,两组比较差异有统计学意义(t=18.462,t=19.037,t=18.759,t=19.338;P<0.05);观察组并发症发生率较对照组更低,两组比较差异有统计学意义(x^(2)=6.874,P<0.05)。结论:给予食管狭窄患者使用内窥镜辅助下球囊扩张,可显著改善患者的吞咽功能,并发症低,可提高生活质量,降低食管再狭窄发生率及延长再狭窄发生间隔时间。

Objective:To investigate the effect of balloon dilatation treatment under erthyphoria with endoscopy on the clinical efficacy and QOL score of patients with esophageal stenosis.Methods:88 patients with esophageal stenosis who were confirmed and treated in hospital were selected.The esophageal stenosis of them were caused by radiotherapy for esophageal cancer.All of them were divided into control group and observation group,with 44 cases in each group.The data of diagnosis and treatment of all patients were retrospectively analyzed and were evaluated according to different treatment methods.Probe dilatation was used in the control group and balloon dilatation was used in observation group.The incidence rate and interval time of esophageal restenosis were observed and compared between two groups.In addition,the indicators of curative efficacy and the distribution of swallowing function rating,the differences and changes in QOL scores before and after treatment,and the complications between two groups also were observed and compared.Results:The incidence rate of esophageal restenosis of observation group(34.1%)was significantly lower than that of control group(56.8%)(x^(2)=6.152,P<0.05).The interval time of esophageal restenosis of observation group(3.5±0.8 months)was significantly longer than that of control group(1.9±0.7 months)(t=18.374,P<0.05).The ratio of grade 0 of swallowing function rating after treatment of observation group was significantly higher than that of control group(x^(2)=6.294,P<0.05).The physical function,emotion function,social function and QOL score which was related to emesis and nausea after treatment in observation group were significantly higher than those in control group(t=18.462,t=19.037,t=18.759,t=19.338,P<0.05).The incidence rate of complication of observation group was significantly lower than that of control group(x^(2)=6.874,P<0.05).Conclusion:The balloon dilatation treatment under auxiliary with endoscopy on patients with esophageal stenosis can significantly improve the swallowing function of patients,which complications are low.It can improve quality of life,and reduce the incidence rate of esophageal restenosis and prolong the interval time of occurring restenosis.