摘要
目的探讨黏膜下注射曲安奈德对早期食管癌患者内镜黏膜下剥离术后食管良性狭窄的效果。方法选取2019年3月至2020年3月间陕西省森林工业职工医院收治的60例早期食管癌内镜黏膜下剥离术后良性狭窄的患者,根据治疗方法不同进行分组,其中,采用内镜下扩张治疗的30例患者纳入对照组,在内镜下扩张治疗后立即于黏膜下注射醋酸曲安奈德的30例患者纳入观察组。比较两组患者的临床治疗效果、吞咽困难分级评分、持续症状缓解时间、再次扩张时间间隔及术后并发症发生率。结果观察组患者的治疗总有效率为93.3%,高于对照组患者的70.0%,差异有统计学意义(P<0.05)。治疗后,两组患者吞咽困难分级评分均降低,且观察组低于对照组,差异均有统计学意义(均P<0.05)。观察组患者治疗后持续症状缓解时间和再次扩张时间间隔均长于对照组患者,差异均有统计学意义(均P<0.05)。两组患者出血、吻合口紊乱、发热、胸痛和反流性食管炎等并发症发生率比较,差异无统计学意义(P>0.05)。结论黏膜下注射曲安奈德治疗早期食管癌患者内镜黏膜下剥离术后食管良性狭窄的临床效果较好,可改善患者的吞咽困难,提高持续症状缓解时间和再次扩张时间间隔,且不增加并发症发生率,值得临床借鉴。
Objective To investigate the efficacy of submucosal injection of triamcinolone acetonide for benign esophageal stricture after endoscopic submucosal dissection in patients with early esophageal cancer.Methods Sixty patients with benign esophageal stricture who were admitted to Shaanxi Sengong Hospital and underwent endoscopic submucosal dissection were selected from March 2019 to March 2020 as the research subjects.They were divided into two groups based on the treatment they received.Thirty patients receiving submucosal injection of triamcinolone acetonide immediately after endoscopic submucosal dissection were included in an observation group and 30 patients receiving esophageal dilation were included in a control group.The clinical therapeutic efficacy,Stooler's dysphagia scale score,duration of symptom relief,interval of re-dilation,and incidence of postoperative complications were compared between the two groups.Results The overall efficacy rate was 93.3%in the observation group which was significantly higher than 70.0%of the control group(P<0.05).There was no statistically significant difference in Stooler's dysphagia scale score between the two groups before the treatment(P>0.05).Stooler's dysphagia scale score were significantly reduced in the two groups after treatment,and score was significantly lower in the observation group than in the control group(all P<0.05).The duration of symptom relief and the interval of re-dilation were significantly longer in the observation group than in the control group after the treatment(all P<0.05).There was no significant difference in the incidence of complications between the two groups including blood loss,anastomotic leakage,fever,chest pain and reflux esophagitis(P>0.05).Conclusion The clinical efficacy of submucosal injection of triamcinolone acetonide shows high efficacy for the treatment of benign esophageal stricture after endoscopic submucosal dissection in patients with early esophageal cancer,which can relieve dysphagia and shorten the duration of symptom relief and the interval of re-dilation without increasing the incidence of complications,which is worthy of clinical reference.
作者
姜红波
王力
田莉
JIANG Hong-bo;WANG Li;TIAN Li(Department of Gastroenterology,Shaanxi Sengong Hospital,Xi'an 710300,China;Department of Gastroenterology,Xi'an XD Group Hospital,Xi'an 710077,China)
出处
《中国肿瘤临床与康复》
2020年第10期1232-1234,共3页
Chinese Journal of Clinical Oncology and Rehabilitation
关键词
曲安奈德
食管肿瘤
内镜黏膜下剥离术
食管良性狭窄
Submucosal injection of triamcinolone acetonide
Endoscopic submucosal dissection
Benign esophageal stricture
Effectiveness
