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1、内镜下Savary扩张器扩张治疗食管贲门狭窄临床观察邹绍静刘仕鹏汪忠红(通讯作者)贾华锋袁开胜程如焕(洪泽县人民医院江苏淮安223100)【摘要】目的:探讨内镜引导Savary扩张器扩张治疗食管贲门狭窄的临床疗效。方法:对98例食管贲门狭窄患者行内镜引导下Savary扩张器扩张治疗。结果:98例患者中共行132次扩张。有效率98%(96/98)。治疗前狭窄管径直径(4.93±0.11)mm,扩张术后(12.73±0.05)mm,治疗后狭窄部位直径显著大于术前(t=74.529
2、,P=0.000)。术后发生上消化道出血1例,穿孔1例,经内科保守治疗治愈。结论:内镜引导Savary扩张器扩张治疗食管贲门狭窄安全有效,值得临床推广。【关键词】Savary扩张器;扩张术;食管贲门狭窄【中图分类号】R571【文献标识码】A【文章编号】2095-1752(2016)17-0188-02Clinicalobservationofendoscope-guidedsavarybougiedilatationforesophagealandcardiacstrictureZouShaojing,
3、LiuShipeng,WangZhonghongjiaHafeng,YuanKaisheng,ChengRuhuan.DepartmentofgastroenterologyofHongzecountypeople’sHospital,HongzeJangsu,223100,P.R.China【Abstract】ObjectiveTostudytheclinicaleffectofendoscope-guidedsavarybougiedilatationforesophagealandca
4、rdiacstricture.Methods98patientswithesophagealandcardiacstrictureweretreatedwithendoscope-guidedSavarybougiedilatation.Results132timesofsavarybougiedilatationwereperformedfor98patients,Theresponseratewas98%(96/98),Thedifferencebetweetthediameter(4.93&plu
5、smn;0.11)mmofesophagealandcardiacstricturebeforedilatationandthediameter(12.73±0.05)mmofesophagealandcardiacstrictureafterdilatationwasstatisticassysignificant^=74.529,P=0.000).Afterdilatation,onecasewasfounduppergastrointestinalbleedingandonecase
6、wasfounddigestivetractperforation,2caseswerecuredthroughconservativetreatment.ConclusionSavarybougiedilatationisasafeandefficientprocedureintreatingtheesophagealandcardiacstricture.【Keywords】Savarybougie;Dilatation;Esophagealandcardiacstricture食管贲门狭窄是常见的
7、食管贲门疾病的并发症,临床症状主要表现为咽下困难,进食受阻,消瘦明显,生活质量很差,甚至危及患者生命。我院自2008年开展在内镜引导下Savary扩张器扩张治疗食管贲门狭窄,取得较好效果,现报告如下。1.资料与方法1.1一般资料本组98例患者中男67例,女31例,年龄23〜82岁,中位年龄56岁,病史1月〜12年。其中术后吻合U狭窄92例,肿瘤狭窄2例,化学烧伤狭窄1例,贲门失弛缓症1例,放疗后食管狭窄2例。依进食梗阻症状和钡餐造影测量结果,将狭窄程度分为(1)轻度狭窄:进普食困难,狭窄管径5〜10mm
8、;(2)中度狭窄:进半流质食物闲难,狭窄管径在3〜5mm;⑶S度狭窄:进流食闲难,管径<3mm[l]。本组病例中轻度狭窄15例(15.3%>,中度狭窄62例(63.3%),重度狭窄21例(21.4%)。1.2器械选择常州贺利氏微创医疗器械有限公司Savary扩张器一套(直径分别为0.5cm,0.7cm,0.9cm,1.1cm,1.3cm,1.5cm),全长85CM,配套带橄榄头引导钢丝和奥林巴斯公司电子胃镜一套。1.3扩张前准备术前测