腐蚀性物质摄入所致食管狭窄：儿童球囊扩张术的疗效
Oesophageal strictures caused by the ingestion of corrosive agents: effectiveness of balloon dilatation in children.
作者信息
Doo E-Y, Shin J H, Kim J H, Song H-Y
机构信息
Department of Radiology, Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Korea.
出版信息
Clin Radiol. 2009 Mar;64(3):265-71. doi: 10.1016/j.crad.2008.10.001. Epub 2008 Nov 18.
AIM
To evaluate the safety and clinical effectiveness of balloon dilatation in children for oesophageal strictures caused by the ingestion of corrosive agents.
MATERIALS AND METHODS
The study comprised 11 children (median age 6 years; range 1-14 years) with oesophageal strictures caused by corrosive agents, who underwent a total of 36 balloon dilatation sessions. The technical and clinical success, recurrence of dysphagia, complications, and primary and secondary patency rates were retrospectively evaluated.
RESULTS
Technical success was achieved in 91% of patients and in 97% of balloon dilatation sessions. Clinical success (defined as improved food intake and reduced dysphagia within 1 month of the first balloon dilatation session) was achieved in 64% of patients (7/11). During the mean 35-month follow-up period (range 1-89 months), 10 (91%) patients experienced recurrence. Oesophageal rupture (types 1 or 2) occurred in 45% of patients and in 31% of balloon dilatation sessions. Primary patency rates at 6 months and 1, 2, 3, 4, and 5 years were 36, 27, 14, 14, 14, and 14%, respectively. Secondary patency rates at 6 months and 1, 2, 3, 4, and 5 years were 82, 82, 82, 56, 42, and 42%, respectively. The secondary patency rate was higher than the primary patency rate (p<0.05).
CONCLUSION
The present study examined oesophageal balloon dilatation for paediatric oesophageal strictures caused by the ingestion of corrosive agents. Although the technical success rate was high and there were no deaths, the clinical success rate was low owing to a high recurrence rate. However, repeated balloon dilatations resulted in an acceptable secondary patency rate.
目的
评估球囊扩张术治疗儿童腐蚀性物质摄入所致食管狭窄的安全性和临床疗效。
材料与方法
本研究纳入11例因腐蚀性物质导致食管狭窄的儿童（中位年龄6岁；范围1 - 14岁），共进行了36次球囊扩张术。对技术成功率、临床成功率、吞咽困难复发情况、并发症以及初次和二次通畅率进行回顾性评估。
结果
91%的患者和97%的球囊扩张术实现了技术成功。64%的患者（7/11）取得了临床成功（定义为首次球囊扩张术后1个月内食物摄入量增加且吞咽困难减轻）。在平均35个月的随访期（范围1 - 89个月）内，10例（91%）患者出现复发。45%的患者和31%的球囊扩张术发生了食管破裂（1型或2型）。6个月以及1、2、3、4和5年的初次通畅率分别为36%、27%、14%、14%、14%和14%。6个月以及1、2、3、4和5年的二次通畅率分别为82%、82%、82%、56%、42%和42%。二次通畅率高于初次通畅率（p<0.05）。
结论
本研究探讨了球囊扩张术治疗儿童腐蚀性物质摄入所致食管狭窄。尽管技术成功率高且无死亡病例，但由于复发率高，临床成功率较低。然而，重复球囊扩张术导致了可接受的二次通畅率。
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