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目的 了解食管扩张后同时抗反流及糖皮质激素治疗的远期疗效。方法 抗反流治疗包括抑酸剂及促动力药 ,服药时间 4周以上 ;糖皮质激素治疗 :2 2例每次扩张后给予强的松口服治疗 7～ 10d ,其中 17例每次扩张后局部分点注射氢化泼尼松或喷洒氟美松。结果 (1) 4 4例结合抗反流或合用糖皮质激素治疗 ,平均扩张(1 6 8± 0 77)次明显低于 2 0例对照组平均扩张 (2 45± 2 5 4)次 (P <0 0 1)。 (2 )术后吻合口狭窄的病人 47例 ,2 0例给予抗反流治疗 ,13例同时给予抗反流及糖皮质激素治疗 ,平均扩张次数分别为 (1 75± 0 75 )次和 (1 6 1±0 78)次 ,均明显低于对照组 [(n =14,扩张 (3 0 8± 3 0 9)次 ],(P <0 0 1)。结论 抗反流治疗和糖皮质激素的应用能有效减少扩张次数 ,维持远期疗效。
Objective To understand the long-term efficacy of anti-reflux and glucocorticoid therapy after esophageal dilatation. Methods Anti-reflux therapy included antacids and motility drugs, taking more than 4 weeks; glucocorticoid therapy: 22 patients were given prednisone for 7-10 days after each dilatation, of which 17 cases were dilated Point injection of prednisolone or sprayed with dexamethasone. Results (1) In 44 cases treated with anti-reflux or combined glucocorticoid therapy, the mean expansion (16.8 ± 0.77) times was significantly lower than that of the control group (20 45 ± 2 5 4) times (P <0 0 1). (2) There were 47 patients with anastomotic stenosis, 20 patients were treated with anti-reflux therapy, 13 patients were treated with anti-reflux and glucocorticoid therapy, the average number of expansion was (1 75 ± 0 75) times and ( 1 6 1 ± 0 78) times were significantly lower than those in the control group [(n = 14, 30 0 ± 3 0 9 times), P 0 01. Conclusion Anti-reflux therapy and glucocorticoids The application of hormones can effectively reduce the number of expansion, to maintain long-term efficacy.