内镜黏膜下注射糖皮质激素联合扩张术治疗早期食管癌内镜黏膜下剥离术后狭窄的初步探索

目的探讨内镜黏膜下注射糖皮质激素联合扩张术治疗早期食管癌内镜黏膜下剥离（endosc opicsubmucosal dissection，ESD）术后狭窄的疗效。方法回顾性分析2009年1月～2013年1月20例早期食管癌ESD术后狭窄患者资料，内镜黏膜下注射地塞米松5mg（用生理盐水稀释至8ml，分4点注射，每点2m1）联合扩张术（观察组）和单纯扩张术（对照组）各10例，随访6个月，比较2组再狭窄发生的时间。结果2组操作均成功，观察组再狭窄发生时间（41．2±8．9）d，对照组为（28．2±5．8）d（t=3．875，P=0．001）。结论内镜黏膜下注射糖皮质激素治疗早期食管癌ESD术后狭窄是安全且有效的，可延缓再狭窄时间。

Application of Endoscopic Submucosal Triamcinolone Injection Combined with Dilation for Post.ESD Esophageal Stricture in Patients with Superficial Esophageal Cancer

Objective To evaluate clinical efficacy and value of endoscopic triamcinolone injection combined with dilation for post-ESD （endoscopic submucosal dissection） esophageal stricture in patients with superficial esophageal cancer. Methods This study retrospectively analyzed clinical data of 20 cases of post-ESD esophageal stricture for superficial esophageal cancer. Among the 20 cases, 10 received endoscopic triamcinolone injection （5 mg dexamethasone was diluted into 8 ml with normal saline, and was injected at four points in the mucosa layer, with 2 ml per point） combined with dilation （observation group） , another 10 received dilation alone as the control group. All the cases were averagely followed up for 6 months. The time to restenosis was compared between the two groups. Results All the procedures of both groups were successfully completed. The time to restenosis was （41.2 ± 8.9） days in observation group and （28.2 ：l： 5.8） days in control group （ t = 3. 875, P = O. 001 ）. Conclusion Endoscopic triamcinolone injection for post-ESD esophageal stricture in patients with superficial esophageal cancer is safe and effective and can delay the time of restenosis.