目的 回顾性分析食管静脉曲张硬化治疗后食管狭窄发生的相关因素。 方法 收集解放军总医院行食管静脉曲张硬化治疗后发生食管狭窄的32例，与同期未发生狭窄的30例对照分析其临床特点，包括病因、狭窄部位、狭窄程度、硬化次数、硬化点数、硬化剂量及治疗结果等。通过相关因素分析，筛选出狭窄发生的危险因素。 结果 食管静脉曲张硬化治疗后狭窄发生以食管下段为主，狭窄发生部位距门齿距离为（37.31±2.15）cm；平均直径为（7.51±1.45）cm；平均硬化治疗次数为（4.68±1.68）次；总硬化剂量为（105±41.32）ml；狭窄需行内镜下球囊扩张治疗者16例。多因素分析表明，狭窄的发生与硬化剂量及治疗总次数相关；而与年龄、性别、硬化点数等因素无关。 结论 科学掌握硬化治疗剂量、部位与次数，对预防食管静脉曲张硬化治疗后狭窄的发生有重要意义。
Abstract
Objective To analyse retrospectively the causes and characterisics of esophageal stricture following esophageal variceal sclerotherapy in order to optimize the endoscopic treatment of esophageal varices. Methods 1547 patients with esophageal varice were treated by sclerotherapy in the recent seven years, 32 of whom were found to have esophageal stricture. Another 30 patients without stricture were used as controls to analyze the clinical characteristics, especially etiology, stricture location, stricture degree, sclerosis times and points, sclerosis doses, and treatment results. Statistical factor analysis was used to identify stricture-related factors. Results The main causes of portal hypertension in stricture group were HBV cirrhosis and autoimmune hepatitis(AIH), like those without stricture. Stricture was mostly located in the lower part of esophagus. The distance from the stricture to the incisors was（37.31±2.15）cm；the average treatment times were（4.68±1.68）and the total sclerosis dose was （105±41.32）ml. Statistical factor analysis indicated that esophageal stricture was correlated with the total sclerosis dose and treatment times rather than with age, gender and sclerosis points. Conclusions A sound knowledge of the dose, location and frequency of sclerotherapy is significant to preventing the occurrence of esophageal stricture.
关键词
食管静脉曲张 /
硬化治疗 /
食管狭窄 /
因素分析
Key words
esophageal varices /
sclerotherapy /
esophageal stricture /
factor analysis
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