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目的:探讨食管良性狭窄有效的介入治疗方法,并分析发生食管再狭窄的主要原因。对象与方法:50例食管良性狭窄病人,其中35例采用X线下不同型号球囊导管扩张治疗。另15例在X线下置入食管内支架。所有病人治疗前皆有不同程度的吞咽困难。结果:35例食管良性狭窄共进行67次球囊扩张,平均1.9次。摄食能力术前后分级和术后症状复发时分别为1.43±0.80级.4.88±0.83级和1.71±0.82级。食管最狭窄处直径术前后和症状复发时分别为4.02±2.09mm.9.86±2.98mm和4.52±1.95mm。症状缓解1～12月,平均3.14±2.37个月。15例食管良性狭窄支架置入术技术成功率100％。支架置入前后摄食能力分级为0.8±0.84级和3.8±0.45级,食管管腔内径术前后为3.6±1.34mm.18.4±0.89mm。术后随访10天～30月,平均10.5个月。发生再狭窄3例。结论:食管狭窄介入治疗是提高食管良性狭窄治疗短期疗效的首选方法。食管再狭窄主要是肉芽组织增生所致。
Objective: To explore the effective interventional treatment of benign esophageal stenosis and to analyze the main causes of esophageal restenosis. Subjects and Methods: Fifty patients with benign esophageal stenosis, of which 35 cases of different types of balloon catheter dilation under the X-ray treatment. Another 15 cases were placed in esophageal stent under X-ray. All patients had varying degrees of dysphagia before treatment. Results: Thirty-five cases of benign esophageal stricture were performed balloon dilatation with a mean of 1.9 times. Feeding abilities were 1.43 ± 0.80, 4.88 ± 0.83 and 1.71 ± 0.82, respectively, before and after grading and postoperative recurrence. The diameter of esophageal stenosis was 4.02 ± 2.09mm.9.86 ± 2.98mm and 4.52 ± 1.95mm respectively before and after the diameter recurrence. Symptoms were relieved from January to December, with an average of 3.14 ± 2.37 months. 15 cases of esophageal stricture stent placement technology success rate of 100%. The feeding ability before and after stent placement was graded as 0.8 ± 0.84 and 3.8 ± 0.45, and the intra-esophageal lumen diameter was 3.6 ± 1.34mm.18.4 ± 0.89mm before and after operation. The patients were followed up for 10 days to 30 months with an average of 10.5 months. Restenosis occurred in 3 cases. Conclusion: Interventional treatment of esophageal stenosis is the preferred method to improve the short-term efficacy of esophageal stricture. Esophageal restenosis is mainly caused by granulation tissue hyperplasia.