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目的探讨“自助式”食管扩张法治疗食管癌术后吻合口狭窄的疗效及其应用前景。方法对27例食管癌术后吻合口狭窄的患者进行“自助式”食管扩张治疗。每天扩张1次,每次持续30min,1～3周为一个疗程。结果本组27例患者扩张前吞咽困难程度为IV级3例,Ⅲ级10例,Ⅱ级7例,Ⅰ级7例;经1个疗程扩张治疗后,吞咽困难程度改善为I级11例,0级16例,无一例发生食管穿孔等严重并发症。随访228个月,仅1例于扩张7个月后又出现Ⅱ级吞咽困难,经再次扩张后完全缓解。结论“自助式”食管扩张术治疗食管胃吻合口良性狭窄,其疗效可靠,患者痛苦小,安全性高,远期疗效较好,是一种值得推广应用的新式食管扩张方法。
Objective To investigate the curative effect and application prospect of “self-help” esophageal dilatation in the treatment of postoperative anastomotic stricture of esophageal cancer. Methods 27 cases of esophageal cancer patients with anastomotic stenosis after “self-help” esophageal dilation treatment. 1 day of expansion, each lasting 30min, 1 to 3 weeks for a course of treatment. Results In the 27 patients, the degree of dysphagia was 3 in grade IV, 10 in grade Ⅲ, 7 in grade Ⅱ and 7 in grade Ⅰ. After one course of dilation, the degree of dysphagia improved to grade I in 11 cases, 0 grade 16 cases, no case of serious complications such as esophageal perforation. During the follow-up of 228 months, only 1 patient developed grade Ⅱ dysphagia again after 7 months of expansion, which was completely relieved after re-expansion. Conclusion “Self-help” esophageal dilatation for the treatment of esophagogastrostomy benign stenosis, the curative effect is reliable, patients with small pain, high safety, long-term curative effect is good, it is a new esophageal expansion method worthy of promotion.