Hands L J, Papavramidis S, Bishop H, Dennison A R, McIntyre R L, Kettlewell M G
Department of Surgery, John Radcliffe Hospital, Oxford.
Ann R Coll Surg Engl. 1989 Sep;71(5):306-9; discussion 9-10.
A total of 195 patients with benign peptic oesophageal strictures treated by endoscopic dilatation and antireflux medication between July 1977 and July 1986 were studied prospectively to determine the effect of such treatment on the subsequent course of this disease. Of the patients, 58% were female and they were significantly older than the males at the time of initial presentation (75 years vs 68 years, P less than 0.0001). 46% of both sexes required only one dilatation but the men required more dilatations over a longer period: 31% males vs 19% females required more than 3 dilatations (P less than 0.05) and 40% males vs 27% females were being dilated 2 years or more after the initial dilatation (P less than 0.05). Dilatation combined with antireflux medication is clearly an effective method of management for most patients with peptic oesophageal strictures. The value of antireflux surgery requires evaluation for that subset of patients, predominantly males, who require long-term and repeated dilatation.
1977年7月至1986年7月期间，对195例接受内镜扩张和抗反流药物治疗的良性食管消化性狭窄患者进行了前瞻性研究，以确定这种治疗对该疾病后续病程的影响。患者中58%为女性，她们在初次就诊时明显比男性年龄大（75岁对68岁，P<0.0001）。两性中46%仅需一次扩张，但男性在更长时间内需要更多次扩张：31%的男性对19%的女性需要超过3次扩张（P<0.05），40%的男性对27%的女性在初次扩张后2年或更长时间仍在进行扩张（P<0.05）。扩张联合抗反流药物显然是大多数食管消化性狭窄患者的有效治疗方法。对于那些主要为男性、需要长期反复扩张的患者亚组，抗反流手术的价值需要评估。
