Intralesional steroid injection in benign esophageal strictures resistant to bougie dilation
Intralesional steroid injection in benign esophageal strictures resistant to bougie dilation
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DOI：
10.1111/j.1440-1746.2004.03491.x
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发表时间：
2004-12-01
影响因子：
4.1
通讯作者：
Sahin, B
中科院分区：
文献类型：
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作者：
Altintas, E;Kacar, S;Sahin, B
目的：一些良性食管狭窄对探条扩张具有很强的抵抗力。本研究的目的是确定病灶内类固醇注射是否对 Savary-Gilliard 探条扩张疗法 (SGBD) 具有额外益处。方法：21 名患者接受了探条扩张器治疗。将患者随机分为对照组和研究组。对照组有 11 名患者（7 名男性，4 名女性；平均年龄 45.09 +/- 24.64 岁），研究组有 10 名患者（4 名男性，6 名女性；平均年龄 49.40 +/- 16.49 岁）。对照组患者仅接受 SGBD，但研究组患者接受额外的病灶内类固醇注射（每个象限注射 8 mg 醋酸曲安奈德）。将扩张次数除以随访时间（以月为单位），确定周期性扩张指数。结果：研究组与对照组在年龄、性别、病因、病变部位和复发、治疗结果、并发症和扩张次数方面没有差异。在研究组中，注射前后的平均周期性扩张指数分别为 0.712（范围 0.097-2.75）和 0.289（范围 0-1）（P = 0.03）。此外，注射前后的平均扩张次数分别为 5.3 次（范围 2-11）和 1.6（范围 0-5）（P = 0.03）。研究组的平均无症状间隔为 24 +/- 12.75 个月，对照组为 5.18 +/- 5.06 个月（P < 0.001）。研究组总周期扩张指数为0.193±0.123，对照组为0.597±0.583（P < 0.05）。结论：病灶内注射类固醇可提高探条扩张的疗效，并减少重复探条扩张的需要。 (C) 2004 年布莱克威尔出版亚洲有限公司。
Objective: Some benign esophageal strictures are highly resistant to bougie dilation. The aim of this study was to determine whether intralesional steroid injection had additional benefit to Savary-Gilliard's bougie dilation therapy (SGBD).Methods: Twenty-one patients were treated with a bougie dilator. The patients were randomized into control and study groups. There were 11 patients in the control group (7 males, 4 females; mean age 45.09 +/- 24.64 years) and 10 patients in the study group (4 males, 6 females; mean age 49.40 +/- 16.49 years). The patients in the control group underwent only SGBD, but patients in the study group received an additional intralesional steroid injection (8 mg triamcinolone acetate into each quadrant). The number of dilations was divided by the follow-up period (in months) to determine the periodic dilatation index.Results: There was no difference in age, sex, etiology, localization and recurrence of lesions, treatment outcome, complications and the number of dilations between the study and control groups. In the study group, the mean periodic dilatation index was 0.712 (range 0.097-2.75) and 0.289 (range 0-1) before and after injections, respectively (P = 0.03). Additionally, the mean number of dilations was 5.3 (range 2-11) and 1.6 (range 0-5) before and after injections, respectively (P = 0.03). The mean symptom-free interval was 24 +/- 12.75 months in the study group and 5.18 +/- 5.06 months in the control group (P < 0.001). The total periodic dilatation index was 0.193 +/- 0.123 in the study group, while it was 0.597 +/- 0.583 in the control group (P < 0.05).Conclusions: It can be concluded that intralesional steroid injections increase efficacy of bougie dilation and decrease the requirement for repetition of bougie dilatation. (C) 2004 Blackwell Publishing Asia Pty Ltd.