内镜下硬化剂注射术治疗食管静脉曲张破裂出血后并发食管狭窄的内镜下治疗效果(附12例报告)

Endoscopic treatment of esophageal stenosis after esophageal variceal bleeding treated with sclerosing agent(12 cases)

目的 探索内镜下硬化剂注射术(EIS)治疗肝硬化食管静脉曲张破裂出血后并发食管狭窄的内镜下治疗效果。方法 回顾性分析2018年6月-2021年9月杭州市西溪医院12例应用EIS治疗食管静脉曲张破裂出血后并发食管狭窄的患者的临床资料。结果 7例经内镜下球囊扩张术(1~3次)后,吞咽困难症状好转;2例经4次球囊扩张术,再经内镜下瘢痕切开术后,吞咽困难症状才得到缓解;1例经2次球囊扩张术,再经内镜下瘢痕切开术及口服激素治疗后,食管狭窄好转;2例直接行内镜下瘢痕切开术,吞咽困难症状得到缓解。结论 内镜下球囊扩张术是治疗EIS术后并发食管狭窄较为常用的方法,但需要反复多次治疗;内镜下瘢痕切开术能较准确地切开食管狭窄瘢痕组织,疗效较好,但病例数较少,需要今后更多样本量的研究,进一步评估疗效。

Objective To explore the effect of endoscopic treatment of esophageal stenosis after endoscopic injection sclerotherapy(EIS).Methods A retrospective analysis of the treatment of 12 cases of esophageal stenosis after EIS from June 2018 to September 2021 was reviewed.Results After endoscopic balloon dilation(1~3 times)in 7 patients,the dysphagia symptoms of esophageal stenosis improved;2 patients after 4 balloon dilations and then endoscopic scar incision,the symptoms of dysphagia were relieved;1 patient was treated with endoscopic scar incision and oral hormone therapy after two balloon dilations,and the esophageal stenosis improved;2 patients directly underwent endoscopic scar incision,difficulty swallowing is alleviated.Conclusion Endoscopic balloon dilatation is commonly used to treat esophageal stenosis after EIS,but it needs to be repeated many times;endoscopic scar incision can cut the scar tissue of esophageal stenosis more accurately,and the effect is better.The number of cases in this retrospective analysis is small, and more samples are needed to further evaluate the efficacy.