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消化性食管狭窄患者常因年老而体弱,一般多用保守疗法,即应用纤维内窥镜和Eder-Puestow扩张器经口扩张法,并同时治疗胃食管反流。这是一种简单而安全的方法,作者等对54例患者进行了观察和分析。 54例中,男28例,女31例。年龄为47～90岁,平均69岁,其中65岁以上占69％。在行初次扩张术时,所有病人的狭窄管腔为10mm或更小。39例的狭窄部位在食管下段,15例在食管中1/3,其中3例的食管粘膜为柱状上皮覆盖(Barrett食管)。步骤:用一根Puestow不锈钢导针,经OlympusGIF-K或GIF-P_2内窥镜的活检管道插入,在直视下通过狭窄部。然后去除内窥镜,留下金属导针于原位上,狭窄处用金属橄榄形物沿导针来回扩张,自F23号(直径7.3mm)逐渐增加至F45号(直径14.3mm)。每次
Patients with digestive esophageal stenosis often due to frail elderly, the general use of conservative treatment, that is, the use of fiber endoscopy and Eder-Puestow dilator oral dilation method, and concurrent treatment of gastroesophageal reflux. This is a simple and safe method, the authors of 54 patients were observed and analyzed. 54 cases, 28 males and 31 females. Aged 47 to 90 years, mean 69 years, of which over 65 accounted for 69%. The stenotic lumen of all patients was 10 mm or less at the initial dilation. The stenosis of 39 cases was in the lower esophagus and 15 cases were in the esophagus, of which 3 cases were covered with columnar epithelium (Barrett’s esophagus). Procedure: Insert a Puestow stainless steel guide needle through the biopsy tubing of the Olympus GIF-K or GIF-P 2 endoscope and through the stenosis under direct vision. The endoscope is then removed, leaving the metal guide needle in place. The stenosis is expanded back and forth along the guide pin with a metal olive, increasing gradually from F23 (7.3 mm in diameter) to F45 (14.3 mm in diameter). Each