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目的 探讨内镜下不同介入治疗方法对食管贲门吻合口癌性狭窄的疗效及适应证。方法 将 14 7例食管贲门吻合口癌性狭窄的患者分为单纯沙氏探条扩张组 5 8例 ,内镜下微波加局部化疗组 41例 ,国产金属支架置入治疗组 48例 ,各组在年龄、性别及Stooler分级方面经统计学处理无明显差异。结果 单纯沙氏探条扩张组吞咽困难进步 1～ 2级 ,1次治疗后有效率为 97 3 5 % ,随访 3～ 18个月 ,3 0例存活。内镜下微波加局部化疗治疗组经 2～ 3次治疗后吞咽困难进步 1～ 3级 ,经 3次微波加局部化疗后有效率为 95 13 % ,随访 3～ 2 1个月 ,3 0例存活。金属支架置入治疗组 45例 1次置入成功 ,3例第 2次植入成功 ,吞咽困难进步 1～ 4级 ,总有效率达10 0 % ,随访 3～ 2 8个月 ,42例存活 ,6例死于全身衰竭。结论 金属支架置入治疗疗效最好 ,再狭窄及出血、穿孔的发生率低 ,且对有食管气管瘘的患者可经置入带膜支架从而达到堵塞瘘口的作用
Objective To investigate the efficacy and indications of endoscopic interventional treatment of esophageal and gastric anastomotic stricture. Methods Forty-seven patients with carcinoma of the esophagus and cardiac anastomotic stricture were divided into two groups: 58 cases in the simple Sahs probe expansion group, 41 cases in the endoscopic microwave plus local chemotherapy group, 48 cases in the domestic metal stent group, and 48 cases in each group No statistically significant differences in age, gender and Stooler classification were observed. Results Swab probe expansion alone group dysphagia improved 1 to 2, the effective rate was 97 3 5% after one treatment, followed up for 3 to 18 months, 30 patients survived. Endoscopic microwave plus local chemotherapy group after 2 to 3 times the treatment of dysphagia progress 1 to 3, after 3 times microwave plus local chemotherapy, the effective rate was 95.13%, followed up for 3 ~ 21 months, 30 cases Survival. Forty-five metal stents were successfully implanted in one case, the second implantation was successful in 3 cases, the grade of dysphagia was improved from 1 to 4, the total effective rate was 100%. The patients were followed up for 3 ~ 28 months and 42 survived , 6 died of systemic failure. Conclusion Metal stents have the best curative effect, restenosis and hemorrhage, and the incidence of perforation is low. Patients with esophageal tracheal fistula can be implanted into the stent-graft to achieve the effect of blocking the fistula