复方倍他米松激素局部注射治疗食管癌术后吻合口良性狭窄的效果观察

Observation on the Effect of Local Injection of Compound Betamethasone Hormone in the Treatment of Benign Anastomotic Stenosis after Esophageal Cancer Surgery

目的探讨复方倍他米松激素局部注射治疗行内镜下探条扩张术的食管癌术后吻合口良性狭窄的效果。方法选取本院收治的食管癌术后并发吻合口良性狭窄行内镜下探条扩张术的患者92例,将局部注射复方倍他米松激素的49例患者纳入观察组,将局部注射生理盐水的43例患者纳入对照组。对比两组吻合口狭窄直径,达到总体食管通畅的扩张次数与治疗时间,再狭窄发生率,再狭窄发生时间和并发症发生率。结果两组首次行扩张术后吻合口狭窄直径,无显著差异(P>0.05);观察组达到总体食管通畅的扩张次数与治疗时间少于对照组(P<0.05);观察组再狭窄发生率低于对照组(P<0.05);观察组再狭窄发生时间长于对照组(P<0.05);两组并发症总发生率比较,无显著差异(P>0.05)。结论复方倍他米松激素局部注射治疗行内镜下探条扩张术的食管癌术后吻合口良性狭窄,临床效果显著,能显著减少探条扩张术应用次数,缓解食管吻合口狭窄状况,减少术后再狭窄发生率,同时安全性较高。

Objectives To investigate and analyze the effect of local injection of compound betamethasone hormone on the efficacy of endoscopic strip dilatation in patients with benign anastomotic stenosis after esophageal cancer surgery.Methods A total of 92 patients with benign anastomotic stenosis after esophageal cancer surgery who underwent endoscopic bougie dilatation in our hospital were selected.The 49 patients who received local injection of compound betamethasone hormone were selected as the observation group,whilethe 43 patients who received local injection of normal saline were included in the control group.The diameter of anastomotic stenosis,the times of dilations and treatment time to achieve overall esophageal patency,the incidence of restenosis,the time of restenosis and the incidence of complications were compared between the two groups.Results There was no significant difference in the diameter of anastomotic stenosis between the two groups after the first dilatation(P>0.05).The times of dilatations and treatment time to achieve overall esophageal patency in the observation group were significantly less than those in the control group(P<0.05).The incidence of restenosis in the observation group was significantly lower than that in the control group(P<0.05).The time of restenosis in the observation group was significantly higher than that in the control group(P<0.05).There was no significant difference in the total incidence of complications between the two groups(P>0.05).Conclusions Endoscopic strip dilatation combined with local injection of compound betamethasone is clinically effective in patients with benign anastomotic stenosis after esophageal cancer surgery.It can significantly reduce theapplication times of bougie dilatation,relieve esophageal anastomotic stenosis,reduce the incidence of postoperative restenosis,and has high safety.