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[儿童腐蚀性食管狭窄内镜下食管扩张治疗的临床分析]

[Clinical analysis of endoscopic esophageal dilation for the treatment of corrosive esophageal strictures in children].

作者信息

Tang Lu-Jing, Lou Jin-Gan, Zhao Hong, Peng Ke-Rong, Yu Jin-Dan

机构信息

Department of Gastroenterology, Children's Hospital, Zhejiang University School of Medicine/National Clinical Research Center for Child Health, Hangzhou 310052, China (Lou J-G, Email:

出版信息

Zhongguo Dang Dai Er Ke Za Zhi. 2023 Dec 15;25(12):1265-1269. doi: 10.7499/j.issn.1008-8830.2305106.

Abstract

OBJECTIVES

To investigate the clinical application of endoscopic esophageal dilation in the treatment of corrosive esophageal strictures in children.

METHODS

A retrospective analysis was performed on the clinical data of 15 children with corrosive esophageal strictures who underwent endoscopic esophageal dilation in Children's Hospital, Zhejiang University School of Medicine. The clinical features, treatment modality of endoscopic esophageal dilation, number of dilations, complications, and prognosis were reviewed.

RESULTS

A total of 96 esophageal dilations were performed in the 15 children with corrosive esophageal strictures, with a median of 6 dilations per child. Among them, 9 children (60%) underwent 6 or more dilations. The children with a stricture length of >3 cm had a significantly higher number of dilations than those with a stricture length of ≤3 cm (<0.05). The children with strictures in a single segment had a significantly better treatment outcome than those with strictures in multiple segments (=0.005). No complication was observed during all sessions of dilation. The overall effective rate (including significant improvement and improvement) of endoscopic esophageal dilation treatment was 87%, with 2 cases of failure.

CONCLUSIONS

Endoscopic esophageal dilation is an effective and relatively safe treatment method for corrosive esophageal strictures in children, and children with strictures in a single segment tend to have a better treatment outcome than those with strictures in multiple segments.

摘要

目的

探讨内镜下食管扩张术在儿童腐蚀性食管狭窄治疗中的临床应用。

方法

对浙江大学医学院附属儿童医院15例接受内镜下食管扩张术治疗的儿童腐蚀性食管狭窄患者的临床资料进行回顾性分析。回顾其临床特征、内镜下食管扩张术的治疗方式、扩张次数、并发症及预后情况。

结果

15例儿童腐蚀性食管狭窄患者共进行了96次食管扩张,平均每名儿童扩张6次。其中,9例(60%)患者接受了6次或更多次扩张。狭窄长度>3 cm的儿童扩张次数明显高于狭窄长度≤3 cm的儿童(<0.05)。单节段狭窄的儿童治疗效果明显优于多节段狭窄的儿童(=0.005)。所有扩张过程中均未观察到并发症。内镜下食管扩张术治疗的总有效率(包括显著改善和改善)为87%,2例治疗失败。

结论

内镜下食管扩张术是治疗儿童腐蚀性食管狭窄的一种有效且相对安全的治疗方法,单节段狭窄的儿童治疗效果往往优于多节段狭窄的儿童。

相似文献

本文引用的文献

1
[Expert consensus on diagnosis and treatment of esophageal stricture in Chinese children].
Zhonghua Er Ke Za Zhi. 2023 Jul 2;61(7):588-593. doi: 10.3760/cma.j.cn112140-20230417-00277.
2
Predictors of clinical response of esophageal dilatations in pediatric population.预测小儿食管扩张临床反应的因素。
J Pediatr Surg. 2022 Jun;57(6):1127-1131. doi: 10.1016/j.jpedsurg.2022.01.037. Epub 2022 Jan 31.
4
Endoscopic Management of Refractory Benign Esophageal Strictures.内镜治疗难治性良性食管狭窄。
Dysphagia. 2021 Jun;36(3):504-516. doi: 10.1007/s00455-021-10270-y. Epub 2021 Mar 12.

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