内镜下食管扩张治疗儿童腐蚀性食管狭窄的临床分析

Clinical analysis of endoscopic esophageal dilation for the treatment of corrosive esophageal strictures in children

摘要:

目的 探讨内镜下食管扩张术在儿童腐蚀性食管狭窄治疗中的临床应用。方法 回顾性收集在浙江大学医学院附属儿童医院进行内镜下食管扩张治疗的15例腐蚀性食管狭窄患儿的临床资料，分析其临床特征、内镜下食管扩张治疗方式、扩张次数、并发症及预后等情况。结果 15例患儿共进行96例次内镜下食管扩张治疗，每位患儿中位扩张次数为6次，其中扩张次数≥6次者9例（60%）。食管狭窄长度>3 cm患儿食管扩张治疗次数明显多于狭窄长度≤3 cm患儿（P<0.05）。单一狭窄段患儿治疗疗效优于多个狭窄段患儿（P=0.005）。所有扩张治疗过程中无一例发生并发症。内镜下食管扩张治疗总有效率（显效及有效）为87%，2例失败。结论 内镜下食管扩张是治疗儿童腐蚀性食管狭窄的有效方法，且相对安全；单一狭窄段患儿食管扩张治疗疗效优于多段狭窄段患儿。］

Abstract:

Objective To investigate the clinical application of endoscopic esophageal dilation in the treatment of corrosive esophageal strictures in children.Methods A retrospective analysis was performed on the clinical data of 15 children with corrosive esophageal strictures who underwent endoscopic esophageal dilation in Children's Hospital, Zhejiang University School of Medicine. The clinical features, treatment modality of endoscopic esophageal dilation, number of dilations, complications, and prognosis were reviewed.Results A total of 96 esophageal dilations were performed in the 15 children with corrosive esophageal strictures, with a median of 6 dilations per child. Among them, 9 children (60%) underwent 6 or more dilations. The children with a stricture length of >3 cm had a significantly higher number of dilations than those with a stricture length of ≤3 cm (P<0.05). The children with strictures in a single segment had a significantly better treatment outcome than those with strictures in multiple segments (P=0.005). No complication was observed during all sessions of dilation. The overall effective rate (including significant improvement and improvement) of endoscopic esophageal dilation treatment was 87%, with 2 cases of failure.Conclusions Endoscopic esophageal dilation is an effective and relatively safe treatment method for corrosive esophageal strictures in children, and children with strictures in a single segment tend to have a better treatment outcome than those with strictures in multiple segments.