影响内窥镜球囊扩张治疗良性食管狭窄临床应用的因素

来源 :世界核心医学期刊文摘(胃肠病学分册) | 被引量 : 0次 | 上传用户:lj780427
下载到本地 , 更方便阅读
声明 : 本文档内容版权归属内容提供方 , 如果您对本文有版权争议 , 可与客服联系进行内容授权或下架
论文部分内容阅读
Background and Study Aims: The purpose of this study was to investigate the safety and clinical effectiveness of a controlled radial expansion (CRE) balloon catheter in dilating benign esophageal strictures, and to assess factors influencing the effectiveness of this procedure. Patients and Methods:From February 2000 to June 2002, 25 patients with documented benign esophageal strictures at our hospital were enrolled and treated with CRE balloon dilation. There were 17 men and eight women,with ages ranging from 30 to 82 years. The average age of the enrolled patients was 56.1 years. All of the strictures were dilated using CRE dilators under direct visualization, without fluoroscopic monitoring. The dilation diameters were planned in series up to 15 mm using a “ rule of three” . If dysphagia and esophageal strictures recurred during the clinical follow-up after completion of a series of dilations, additional dilation was carried out until symptomatic relief was achieved. Effective treatment was defined as the ability of patients with or without repeated dilations to maintain a solid or semisolid diet for more than 12 months. Depending on the effectiveness and duration of treatment, the patients were divided into three groups: group A, the successful group in which the initial series of dilations was effective without the need for any additional dilation for recurrent strictures or dysphagia; group B, the relapse group, in which the initial series of dilations was effective, but additional dilations were needed due to recurrent strictures or dysphagia;and group C, the group in which the initial series of dilations failed or consecutive dilations could not be carried out due to intolerance. Results: The 25 patients received a total of 95 sessions of dilation (3.8 ± 1.2 sessions per patient). There were 11 patients in group A, 11 patients in group B, and three patients in group C. The median follow-up period was 16.5 months (range 12-32 months). The number of initial dilations required to achieve symptomatic relief showed a negative correlation with the pre-dilation diameter of the strictures (r =-0.92, P < 0.01).Thinner strictures required more dilations before symptomatic relief was achieved. In addition, the stricture length in group B (5.4 ± 3.4 cm) was significantly longer than that in group A(2.6 ± 1.1 cm) (P= 0.009). The overall success rate was 88% (22 of 25), including 100% in the 21 patients with a stricture length of less than 8 cm and 25% in the four patients with a stricture length more than 8 cm (P = 0.02). Conclusions: CRE balloon dilation without fluoroscopy is an effective treatment for esophageal strictures less than 8 cm in length. Predilation diameter and stricture length are factors that influence the numbers of dilations required and the need for additional dilations. Background and Study Aims: The purpose of this study was to investigate the safety and clinical effectiveness of a controlled radial expansion (CRE) balloon catheter in dilating benign esophageal strictures, and to assess factors influencing the effectiveness of this procedure. Patients and Methods: From February 2000 to June 2002, 25 patients with documented benign esophageal strictures at our hospital were enrolled and treated with CRE balloon dilation. There were 17 men and eight women, with ages ranging from 30 to 82 years. The average age of the enrolled patients was 56.1 years. All of the strictures were dilated using CRE dilators under direct visualization, without fluoroscopic monitoring. Without dilation of using dilators using CRE dilators under direct visualization, without fluoroscopic monitoring. up after completion of a series of dilations, additional dilation was carried out until symptomatic relief was achieved. Effective t dependent on the effectiveness and duration of treatment, the patients were divided into three groups: group A, the successful group in which the initial series of dilations was effective without the need for any additional dilation for recurrent strictures or dysphagia; group B, the relapse group, in which the initial series of dilations was effective, but additional dilations were due due to recurrent strictures or dysphagia; and group C, the group in which the initial series of dilations failed or consecutive dilations could not be carried out due to intolerance. Results: The 25 patients received a total of 95 sessions of dilation (3.8 ± 1.2 sessions per patient). There were 11 patients in group A, 11 patients in group B, and three patients in group C. The median follow-up period was 16.5 months (range 12-32 months). The number of initi al dilations required to achieve symptomatic relief showed a negative correlation with the pre-dilation diameter of the strictures (r = -0.92, P <0.01). Thinner strictures required more dilations before symptomatic relief was achieved. (5.4 ± 3.4 cm) was significantly longer than that in group A (2.6 ± 1.1 cm) (P = 0.009). The overall success rate was 88% (22 of 25), including 100% in the 21 patients with a stricture length of less than 8 cm and 25% in the four patients with a stricture length more than 8 cm (P = 0.02). Conclusions: CRE balloon dilation without fluoroscopy is an effective treatment for esophageal strictures less than 8 cm in length. Predilation diameter and stricture length are factors that influence the numbers the dilations required and the need for additional dilations.
其他文献
【本刊讯】4月12日至14日,中国成人教育协会成人高等教育理论研究会第十四届年会在杭州召开。本届年会由中国成协成人高等教育理论研究委员会和浙江工 From April 12 to Apr
元末朱元璋部红军中发生的邵荣叛乱事件(1362),历来为官私记载避忌。由常见《明太祖实录》和新近刊布俞本《纪事录》可证,邵荣在叛乱前长期为江南红军中地位仅次于朱元璋、远
周口市审计局召开全市精神文明创建工作会,会议对全市审计系统今后一段时期精神文明建设工作进行了安排部署。图为工人们正在周口市审计局院内进行绿化美化工作现场。 Zhouk
单兵多用途攻坚武器是对由单兵携行、并具有多种作战效能的步兵近战武器系统的统称,它可分为重复装填型与一次性使用型两大类型。由于后者比前者具有质量轻、体积小、结构简
闽东柘荣是福建省最小的一个县,县域面积小,县城也小。可小县城却有两个城,大的称下城,小的称上城,均用城墙围起来。其中下城(又名柘洋城,当年主城)城墙周长八百六十一丈,高
马风屯位于辽宁海城东约25华里,原来叫马疯屯,也叫过马夫屯。唐太宗年间,与辽东半岛隔江相望的高丽国突然兴兵做乱,屡犯边关。唐太宗封大将军薛礼作为征东大元帅,率兵平定战
在登封少林寺西初祖庵千佛阁内立有一通《癸未赓韵再题面壁影》石碑,横长形,高40厘米、宽60厘米;碑文为行草,阴文,字径5厘米,共44字9行。此碑刻不仅字体淳朴自然,流利妍美,端
《蒋勋讲宋词》中作者说,自己最喜欢北宋。像欧阳修、王安石这些人,都可以进退不失据,是因为他们都有一种对人格的完美要求,他们做官不是为别人而做,而是为了他们自己的理想,所以他们非常清楚做官与不做官之间的分寸。苏东坡不会因为被下放了就不做事,他要做的事情反而更多。他被贬到岭南,觉得那里的荔枝很好吃,这意味着他并非完全为了政治而活,他还有别的事情可以做,比如写一篇洋洋洒洒的文章,告诉人家荔枝多好吃。  
海绵窦血栓形成(cavernous sinus thrombosis,CST)早在1821年由Duncan首先描述,是中枢神经系统(CNS)罕见的致死性感染性疾病,在抗生素应用之前病死率可高达80%,目前因诊断延