体外自助式扩张球囊治疗难治性上消化道良性狭窄的临床研究

Clinical study of self-help inflatable balloon for refractory benign upper digestive tract stricture

摘要:

目的 探讨体外自助式扩张球囊治疗难治性上消化道良性狭窄的可行性、有效性和安全性。方法 回顾性分析2022年11月－2024年2月该院10例因上消化道难治性良性狭窄行体外自助式扩张球囊治疗的患者的临床资料。记录内镜下治疗情况、术中及术后并发症发生率、术前术后吞咽困难评分、体外自助式扩张球囊佩戴时间，以及临床疗效。结果 10例患者均接受体外自助式扩张球囊治疗，所有患者在佩戴球囊过程中未出现出血和穿孔等并发症，球囊放置时间为60～180 d，平均佩戴时间104.9 d。术前9例狭窄段长度 < 2 cm，1例狭窄段长度为6 cm。术前吞咽困难评分为（3.60±0.52）分，摘除体外自助式扩张球囊后当天吞咽困难评分为（0.60±0.52）分，术前术后比较，差异有统计学意义（P < 0.05），摘除体外自助式扩张球囊术后3个月吞咽困难评分为（0.70±0.48）分，术后当天与术后3个月吞咽困难评分比较，差异无统计学意义（P > 0.05）。自助式球囊扩张前和扩张后狭窄处直径分别为（5.09±2.02）和（10.35±0.73）mm，扩张前后比较，差异有统计学意义（P < 0.05）。咽喉部疼痛、鼻翼痛和球囊移位是最常见的术后并发症，发生率分别为30.0%（3/10）、50.0%（5/10）和70.0%（7/10）。结论 体外自助式扩张球囊治疗难治性上消化道良性狭窄安全、有效，且可行。值得临床推广应用。

Abstract:

Objective To investigate the efficacy and safety of self-help inflatable balloon in the treatment of refractory benign upper digestive tract stricture.Methods From November 2022 to February 2024, 10 patients with refractory benign upper digestive tract stricture underwent self-help inflatable balloon were retrospectively analyzed. Preoperative treatment, intraoperative and postoperative complications, dysphagia score before and after surgery, wearing time of external self-help inflatable balloon, and the clinical efficacy were evaluated.Results All the 10 patients received self-help inflatable balloon treatment. No complications such as bleeding and perforation occurred in all patients during the wearing of the balloon. The placement time of the balloon was 60 ~ 180 d, and the average wearing time was 104.9 d. Before surgery, nine cases had a stricture segment length less than 2 cm , and one case had a stricture segment length of 6 cm. The dysphagia score before surgery was (3.60 ± 0.52), and the dysphagia score after removal of the self-help inflatable balloon was (0.60 ± 0.52), and there was statistical significance in preoperative and postoperative comparison (P < 0.05). The dysphagia score 3 months after removal of the external self-help inflatable balloon was (0.70 ± 0.48), there was no significant difference in dysphagia score between the day after surgery and 3 months after surgery (P > 0.05). The diameter of the stricture before and after operation was (5.09 ± 2.02) mm and (10.35 ± 0.73) mm respectively, and the difference was statistically significant (P < 0.05). Sore throat, wing of nose pain and balloon displacement were the most common adverse events, with 30.0% (3/10), 50.0% (5/10) and 70.0% (7/10),respectively.Conclusion It is safe, effective and feasible to treat refractory benign upper digestive tract stricture with self-help inflatable balloon in vitro. It is worthy for clinical application.