小探头超声辅助内镜下放射状切开术治疗上消化道瘢痕性狭窄

Treatment of benign upper gastrointestinal tract cicatricial strictures by miniprobe sonography assisted endoscopic radial incision

摘要:

目的 探讨小探头超声（MPS）辅助内镜下放射状切开术（ERI）治疗难治性上消化道瘢痕性狭窄的有效性和安全性。方法 收集2017年11月－2020年1月因上消化道狭窄行MPS评估并行ERI治疗的患者30例，分析患者治疗前和治疗后狭窄改善程度及手术并发症情况，评估其疗效及安全性。结果 30例患者均完成MPS评估后再行ERI，平均操作时间（15.34±2.75）min，所有患者均未出现穿孔和出血等并发症，术前吞咽困难评分为（2.87±0.51）分，术后出院时降至（0.87±0.43）分，术前与术后出院时相比，差异有统计学意义（P < 0.05），术后3和6个月吞咽困难评分分别为（0.90±0.80）和（1.03±0.49）分，与术后出院时比较，差异无统计学意义（P > 0.05）。结论 MPS辅助ERI治疗上消化道瘢痕性狭窄安全、有效，值得临床推广应用。

Abstract:

Objective To investigate the efficacy and safety of miniprobe sonography (MPS) assisted endoscopic radial incision (ERI) in treatment of benign upper gastrointestinal tract cicatricial strictures.Methods From November 2017 to January 2020, 30 patients who underwent MPS evaluation and ERI treatment for upper gastrointestinal tract stenosis were collected, and stenosis improvement after treatment and complications were analyzed to evaluate the efficacy and safety.Results All the 30 patients completed MPS assisted ERI, with an average operation time of (15.34 ± 2.75) min, and no complications such as perforation or bleeding occurred in all patients. The average score of dysphagia before surgery was (2.87 ± 0.51), which was reduced to (0.87 ± 0.43) after surgery, showing statistically significant differences compared with that before surgery (P < 0.05). The score of dysphagia was (0.90 ± 0.80) and (1.03 ± 0.49) at 3 and 6 months postoperatively, and there was no significant difference in dysphagia score compared with that before discharge (P > 0.05).Conclusion MPS assisted ERI is safe and effective in the treatment of benign upper gastrointestinal tract cicatricial strictures. It is worthy of clinical application.