儿童先天性食管裂孔疝伴食管狭窄的综合治疗策略探讨

目的探讨先天性食管裂孔疝导致食管狭窄患儿的食管扩张与食管支架放置、外科手术等综合治疗方法的选择时机及疗效。方法对北京军区总医院2009年12月-2012年9月混合型先天性食管裂孔疝伴严重食管狭窄的9例患儿的临床资料及治疗方案进行分析。结果 9例诊断混合型食管裂孔疝患儿食管扩张后因症状无改善行贲门胃底折叠术,术后放置食管支架,9例患儿术后贲门功能均恢复正常,吞咽困难消失。结论对于伴严重食管狭窄的混合型先天性食管裂孔疝患儿应早期手术治疗,术后辅以食管支架治疗,可达到满意效果。

Exploration of comprehensive treatments for children with congenital esophageal hiatal hernia complicated by esophageal strictures

Objective To further investigate the comprehensive treatment of pediatric patients with esophageal strictures caused by congenital mixed esophageal hiatal hernia.Methods Nine inpatients and outpatients from Feb.2009 to Dec.2012 were diagnosed as having congenital mixed esophageal hiatal hernia with esophageal strictures.Results Nine subjects diagnosed with mixed esophageal hiatal hernia underwent dilations,due to the lack symptom alleviation,cardia fundoplication was performed.Then esophageal stents were placed in nine subjects.Cardia functions were improved significantly in all patients.Conclusion For children with mixed hiatal hernia complicated by esophageal strictures,surgery should be the early treatment,followed by placement of esophageal stent after operation.