食管腔内置管预防食管腐蚀伤后瘢痕狭窄

目的介绍食管腔内置管预防食管腐蚀伤后瘢痕狭窄的手术方法,并评价其疗效。方法食管腐蚀伤后3周内入院33例,除1例发生食管穿孔外均经食管镜检查诊断为度或度烧伤,所有患者均采用食管腔内置管方法预防瘢痕狭窄,4～6个月后拔管。结果本组无手术死亡,拔管后患者均恢复正常进食,食管X线钡餐检查无狭窄。随访1～60个月,随访期间28例进食无梗阻,5例拔管后2～3个月发生食管狭窄,其中1例经食管扩张治愈,另4例施行食管重建手术,术后进普通食物无梗阻。结论食管腔内置管能预防食管腐蚀伤后瘢痕狭窄,加用异烟肼能增强其疗效。

The Prevention of Stricture Formation with Esophageal Intraluminal Stenting in Patients with Corrosive Esophageal Burns

Objective To introduce the technique of esophageal intraluminal stenting and assess its effect on the prevention of development of stenosis in patients with esophageal burns. Methods Thirty-three patients were admitted less than 3 weeks after ingestion of caustic agents. The second-or third-degree injuries were confirmed by esophogoscopy in all cases, but one with esophageal perforation at admission. Esophageal stenting was performed in all patients and these stents were kept in place for 4 to 6 months. Results There was no death in the series. All patients had a normal intake of food after removal of the stents, and stricture was not found on barium swallow test. Follow-up from 1 to 60 months five cases developed esophageal stenosis from 2 to 3 months after extracting the stents. One of them responded to esophageal bougienage, the remaining 4 patients required esophageal reconstruction and took a normal diet postoperatively. The other 28 patients have a normal diet after the stent removal. Conclusion The esophageal intraluminal stenting is able to prevent the formation of stricture in the aftermath of esophageal burns and its effect will be enhanced plus administering isoniazid.