内镜下不同方式治疗难治性腐蚀性食管狭窄的临床研究(附3例报告)

Clinical study on different methods of endoscopic treatment of refractory erosive esophageal stricture(3 cases)

目的探讨内镜下不同方式治疗难治性腐蚀性食管狭窄的临床疗效。方法回顾性分析3例分别行内镜探条扩张术、支架植入术及内镜下推进式放射状切开术(EPRD)治疗难治性腐蚀性食管狭窄患者的临床资料。结果经反复内镜治疗后,3例患者均获得良好的治疗效果,术中及术后均未出现大出血和穿孔等严重并发症,并且随着治疗次数增多,狭窄缓解时间越长,吞咽困难改善也越明显。3种治疗方式中,支架植入术对吞咽困难的改善效果最明显。结论内镜探条扩张术、支架植入术及EPRD治疗难治性食管狭窄均是安全可行且有效的方法。

Objective To investigate the clinical efficacy of different endoscopic methods in treatment of refractory erosive esophageal strictures.Method Clinical data of three patients with refractory erosive esophageal stenosis treated by endoscopic probe dilation,stent implantation,and endoscopic push-radial dissection(EPRD)were retrospectively analyzed.Result After repeated endoscopic treatment,all the three patients achieved good therapeutic effects,and there were no serious complications such as massive bleeding and perforation during and after operation.With the increase of the number of treatment,the longer the remission time was,the more the dysphagia improved obviously.Among the three treatment methods,stent placement had the most significant improvement in dysphagia.Conclusion Endoscopic dilation,stenting and EPRD are safe,feasible and effective methods for the treatment of refractory esophageal strictures.