摘要
目的观察食管扩张术联合吞咽训练治疗食管癌、贲门癌术后食管吻合口狭窄的疗效及对患者生活质量的影响。方法将135例术后食管吻合口狭窄患者随机分为治疗组及对照组。2组患者均于胃镜指导下应用萨氏扩张器进行食管扩张手术治疗，治疗组在此基础上辅以吞咽训练，每天训练2组吞咽活动，每组10—20次。于治疗前及治疗2、4、8周时检查并记录2组患者进食及吻合口直径变化情况，同时采用SF-36量表对2组患者生活质量进行评定。结果2组患者治疗后其进食功能均有不同程度改善，其中I级狭窄患者吻合口直径组间差异无统计学意义（P〉0．05）；Ⅱ级狭窄及Ⅲ级狭窄患者吻合口直径组间差异均有统计学意义（P〈0．05），并以治疗组的改善幅度及疗效持续时间较显著；对2组Ⅱ级及Ⅲ级狭窄患者SF－36量表评分结果比较后发现，治疗后2组患者生活质量均有一定程度改善（P〈0．05），且以治疗组的改善幅度较显著，与对照组比较，组间差异具有统计学意义（P〈0．01）。结论食管狭窄扩张术联合吞咽训练能进一步巩固扩张疗效，延缓吻合口发生再狭窄时间，从而改善患者进食功能，促使生活质量提高，并且该联合疗法具有安全、有效、操作简单等特点，值得临床推广应用。
Objective To assess the therapeutic effect and quality of life （QOL） of patients with anastomotie stenosis after bougienage of esophagus following resection of esophagus with esophageal and of cardiac carcinoma. Methods A total of 135 patients suffering from anastomotic stenosis after resection operations were divided into a treatment group and a control group at random. All patients were given an esophageal dilator under gastroscope. In treatment group, deglutition training was given additionally, twice daily, 10 to 20 trials in each session. Therapeutic effect was evaluated according to patients＇ food intake and gastroscopy results of diameter of stenosis before treatment and 2,4,8 weeks after treatment. QOL was evaluated with Chinese version of SF-36 instrument. Results The food intake of all the patients improved. There was no difference of diameter of stenosis in degree I stenosis patients between two groups （P 〉 0.05） ; but the differences were statistically significant in degree II and Ⅲ stenosis patients （P 〈 0.05）. In treatment group, the degree and duration of improvement were more obvious. QOL of patients with degree Ⅱ and m stenosis in both groups improved significantly after treatment （P 〈 0.05） , but compared with control group the improvement was significantly greater in treatment group （ P 〈 0.05 ）. Conclusion The therapeutic effect of bougienage of esophagus can be strengthened with deglutition training. This combinative therapy is safe and effective.
出处
《中华物理医学与康复杂志》
CAS
CSCD
北大核心
2009年第8期538-541,共4页
Chinese Journal of Physical Medicine and Rehabilitation
关键词
吞咽扩张训练
食管扩张术
吻合口狭窄
生活质量
SF-36量表
Deglutition rehabilitation training
Bougienage of esophagus
Anastomotie stenosis
Quality of life
SF-36 instrument
