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[经气囊扩张治疗的食管狭窄的长期病程。与其他方法的对比研究]

[Long-term course of esophageal stenosis treated with pneumatic dilatation. A comparative study versus other methods].

作者信息

Cano Novillo I, Vilariño Mosquera A, Serrano Hernández C, Portela Casalod E, Berchi García J F

出版信息

Cir Pediatr. 1989 Oct;2(4):178-82.

PMID:2488077
Abstract

Dilatation of benign esophageal strictures by means of a balloon catheter is a well established procedure in children. In this report a comparison of bouginage and balloon dilatation is made in eight patients treated by both procedures. The lesions treated included two strictures secondary to surgical anastomosis, one restrictive Nissen fundoplicature and five esophageal stenosis following caustic ingestion. These eight patients had a total of 44 bouginage procedures with a mean relapse free period of 80 days. There were two esophageal perforations. The clinical course was unsatisfactory in five cases. Only one patient had good results. In contrast, to date, the 15 balloon dilatations have resulted in a mean relapse free time of 174 days. There were no complications that required treatment. The clinical follow up shows four asymptomatics patients and the other four presenting difficulties to swallow with spontaneous resolution. We have the best results in younger patients with esophageal stenosis secondary to esophageal atresia repair. Balloon dilatation of esophageal stenosis in children is effective and safe, and should be considered before other methods of treatment are used.

摘要

通过球囊导管扩张良性食管狭窄在儿童中是一种成熟的治疗方法。在本报告中,对8例接受了两种治疗方法的患者进行了探条扩张术与球囊扩张术的比较。所治疗的病变包括2例手术吻合口继发狭窄、1例限制性尼森胃底折叠术后狭窄和5例腐蚀性物质摄入后食管狭窄。这8例患者共进行了44次探条扩张术,平均无复发期为80天。发生了2例食管穿孔。5例患者的临床病程不理想。只有1例患者效果良好。相比之下,迄今为止,15次球囊扩张术的平均无复发时间为174天。没有需要治疗的并发症。临床随访显示,4例患者无症状,另外4例患者有吞咽困难但可自行缓解。对于食管闭锁修复术后继发食管狭窄的年轻患者,我们取得了最佳效果。儿童食管狭窄的球囊扩张术有效且安全,在采用其他治疗方法之前应予以考虑。

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