球囊扩张术治疗儿童食管良性狭窄的疗效

The curative effect of balloon dilatation in the treatment of benign esophageal stenosis in child patients

目的 探讨透视下球囊扩张术治疗不同原因的儿童食管良性狭窄的疗效及安全性。方法 回顾性分析2018年3月至2021年5月天津市儿童医院收治的17例食管良性狭窄患儿的临床资料。患儿中,食管闭锁术后吻合口狭窄组(Ⅰ组)8例,腐蚀性食管狭窄组(Ⅱ组)5例,食道裂孔疝加贲门成形术后贲门狭窄1例,贲门失迟缓症1例,先天性食管狭窄1例。患儿存在吞咽困难,经X线钡餐造影确诊食管狭窄后,在放射线引导下进行食管狭窄的球囊扩张治疗,术后随访6~18个月,观察疗效。结果 17例患儿共进行49次球囊扩张术,每例患儿平均扩张2.88次(1~9次),球囊直径为6~25 mm。Ⅰ组患儿扩张成功7例;Ⅱ组患儿成功扩张4例,其余患儿均扩张成功。术后随访6~18个月,长期有效13例,Ⅰ组长期有效6例,Ⅱ组长期有效4例,余患儿均长期有效。术中术后均无严重并发症出现。结论 透视下食管球囊扩张术治疗不同原因儿童食管良性狭窄安全有效。

Objective To investigate the efficacy and safety of balloon dilatation under fluoroscopic guidance in the treatment of benign esophageal stenosis of different causes in child patients. Methods The clinical date of 17 child patients with benign esophageal stenosis, who were admitted to the Tianjin Municipal Children’s Hospital of China between March 2018 and May 2021, were retrospectively analyzed. Fifteen child patients, who previously had received congenital esophageal atresia repair, suffered from anastomotic stenosis(n=8, group A) or corrosive esophageal stenosis(n=5, group B). Four child patients, who had received oesophageal hiatal hernia plus cardioplasty before, suffered from cardia stenosis(n=1), cardia achalasia(n=2)or congenital esophageal stenosis(n=1). After the diagnosis of esophageal stenosis was confirmed by X-ray barium meal examination, balloon dilatation under fluoroscopic guidance was carried out. The child patients were followed up for 6-18 months to observe the efficacy Results A total of 49 procedures of fluoroscopy-guided balloon dilatation were carried out in 17 child patients, with an average of 2.88 times per child patient(range 1-9 times). The diameter of employed balloon was 6-25 mm. Successful esophageal balloon dilatation was achieved in 7 child patients of group A, in 4 child patients of group B, and in all the remaining 6 child patients. All the child patients were followed up for 6-18 months, and long-term effectiveness was obtained in 13 child patients, including 6 child patients of group A, 4 child patients of group B and all the remaining 6 child patients. No serious complications occurred during and after operation in all the child patients.Conclusion For the treatment of benign esophageal stenosis in child patients of different causes, balloon dilatation under fluoroscopic guidance is safe and effective.