摘要
目的评价经内镜球囊扩张治疗小儿上消化道良性狭窄的安全性和有效性。方法回顾性分析该院2008年9月—2014年5月收治的17例上消化道良性狭窄患儿,男性13例,女性4例,年龄9个月~8岁,平均年龄2.4岁。其中,先天性食管狭窄5例,手术后食管狭窄5例,食管化学烧灼伤致瘢痕狭窄1例,贲门狭窄1例,幽门狭窄1例,幽门前狭窄3例,绝大多患儿仅能进食流质或半流质饮食,并伴有呕吐和(或)呕血发生,镜下观察狭窄程度为2~7 mm,平均3.7 mm。所有患儿在全麻下行内镜下球囊扩张治疗,采用OLYMPUS-GIF260电子胃镜,JHY-BD系列球囊扩张导管,球囊直径为别为6~20 mm,球囊长度为5 cm,根据患儿狭窄部位、窄口大小,采用不同型号球囊进行扩张,扩张结束后,再行胃镜检查,观察狭窄口有否出血,测量狭窄口直径以检查扩张效果,同时进行活检或止血等治疗。术后可根据情况予抗酸、保护消化道粘膜及抗感染治疗。结果 9例食管狭窄经球囊扩张治疗后有好转,1例手术后狭窄扩张治疗后局部出现囊腔未再继续给以扩张治疗,3例幽门前狭窄及1例幽门狭窄治疗效果满意,1例咽食管部狭窄治疗后症状未见改善,1例贲门狭窄扩张治疗首次即出现穿孔未再扩张治疗。结论目前内镜下球囊扩张术已成为治疗儿童上消化道良性狭窄的重要方法。术前做好病情评估,了解消化道狭窄的情况及与相关器官的毗邻关系,尽量发现和避免潜在的危险因素,以利选择恰当治疗方式,避免穿孔等并发症的发生。球囊扩张治疗上消化道狭窄方便、安全、并发症少,成功率高,患儿易接受,且可避免不必要的手术治疗,值得临床推广应用。
Objective To evaluate the safety and effectiveness of endoscopic balloon dilation surgery in treatment of children with upper gastrointestinal benign stricture.Methods 17 cases of children with upper gastrointestinal benign stricture admitted and treated in our hospital from September 2008 to May 2014 were selected including 13 cases of males and 4cases of females,the age was between 9 months to 8 years old,2.4 years old on average,5 cases were congenital esophageal stenosis,5 cases with esophageal stenosis after operation,1 case with scar stenosis caused by the esophageal chemical burning,1 case with preventricular stenosis and 3 cases with prepyloric stenosis,and the majority of children could only eat liquid or semi-liquid diet with vomiting and（or） hematemesis,and the stricture degree observed was 2～7 mm,3.7 mm on average,and all children were treated with endoscopic balloon dilation surgery under the general anesthesia,and the OLYMPUS-GIF260 electronic gastroscopy and JHY-BD series balloon dilation catheter were adopted and the balloon diameter and length were respectively 6～20 mm and 5cm,and the stricture site of children was observed and the stricture diameter was measured and the dilation effect was examined at the end of dilation,and the children were given the acid-fast,gastrointestinal mucosa protection and anti-infection treatment after operation.Results 9 cases were improved after the balloon dilation surgery,1 case was not given the dilation treatment after the occurrence of cyst cavity,the treatment effect of 3cases with prepyloric stenosis and 1 case with preventricular stenosis was satisfactory,and the symptom of 1 case was not improved after the pharyngo-esophageal stricture,and 1 preventricular stenosis case was not given the dilation treatment after the first occurrence of perforation.Conclusion Currently,the endoscopic balloon dilation surgery has been an important method of treatment of children with upper gastrointestinal benign stricture,and we should do a good job in the disease e
出处
《中外医疗》
2017年第14期4-7,共4页
China & Foreign Medical Treatment
关键词
内镜治疗
内镜下球囊扩张
上消化道良性狭窄
Endoscopic treatment
Endoscopic balloon dilation
Upper gastrointestinal benign stricture
