论文部分内容阅读
目的探索治疗食管重建术后不同程度吻合口良性狭窄的合理治疗方案。方法治疗食管重建术后吻合口狭窄１８４例。轻、中、重度狭窄分别是７１（３８．６％）、９２（５０．０％）、２１（１１．４％）例。采用选择性程式治疗方案，即确诊后均先试行食管扩张术，反复扩张无效者续用经口食管腔内置管术，扩张失败者改用手术治疗。结果全组施行单纯扩张术、置管术及手术治疗的分别占９３．２％、４．３％及２．５％。三种方法治疗的总有效率１００％，扩张术有效率９５．０％（１５０／１５８），置管术７例，手术４例治愈率分别是１００％（７／７）、１００％（４／４）。轻、中度狭窄扩张成功率１００％，有效率分别是１００％、９２．５％；重度狭窄扩张成功率８５．７％（１８／２１），有效率８７．５％。严重的并发症有食管穿孔２例。结论选择性程式治疗不同程度的食管重建术后吻合口良性狭窄，从简单到复杂，方案合理，使不同程度的吻合口狭窄患者均得到合理治疗，疗效显著，值得推广
Objective To explore a reasonable treatment plan for the treatment of benign stenosis of different degrees after esophageal reconstruction. Methods 184 cases of anastomotic stricture after esophageal reconstruction were treated. Light, moderate, and severe stenosis were 71 (38.6%), 92 (50.0%), and 21 (11.4%) cases, respectively. The use of selective program treatment program, that is, after the diagnosis of esophageal dilatation were first tried, repeated expansion ineffective continued use of oral esophageal cavity built-in tube, expansion failure to switch to surgery. RESULTS: A total of 93.2%, 4.3%, and 2.5% of the entire group were treated with simple dilatation, catheterization, and surgery. The total effective rate of the three methods of treatment was 100%, the efficiency of expansion was 95.0% (150/158), and 7 cases of catheterization were performed. The cure rate of 4 cases was 100% (7/7) and 100% (4). /4). The success rate of mild-moderate stenosis expansion was 100%, the effective rates were 100% and 92.5%, respectively; the success rate of severe stenosis expansion was 85.7% (18/21), and the effective rate was 87.5%. Severe complications include esophageal perforation in 2 cases. Conclusion Selective program for the treatment of benign stricture of anastomosis with different degrees of esophageal reconstruction, from simple to complex, reasonable plan, so that patients with different degrees of anastomotic stenosis are treated with reasonable results, and it is worthy of promotion.