ABSTRACT
Objective Toinvestigatetheinterventionaltreatmentmethodsofbenignesophagealstenosisinchildren,includingballoondilation, stentimplantationandcontinuousballoondilation.Methods 42casesofesophagealstenosisdiagnosedbybariumexaminationinour hospitalfromJanuary2010toJune2017.Accordingtothetreatmentmethods,theyweredividedintoballoondilationgroup(13cases),stent implantationgroup (11cases),continuousballoondilationgroup (18cases),andthecomplicationsandrecurrenceratesofthree methodswerecompared.Results Balloonorstentsweresuccessfullyplacedorremovedinallcases,andtheclinicalsymptomswere significantlyimproved.Therewerenoseriouscomplicationssuchasruptureofesophagus,perforationandmassivehemorrhageI.nballoondilation group,restenosisoccurredin10cases3to10monthsafteroperation,withcomplicationsrateof76.9% andrecurrencerateof76.9%. Instentimplantationgroup,sentfallingoffordisplacedoccurredin4casesandrestenosisin4cases,withthecomplicationsrateof 72.7% andrecurrencerateof36.3%.Incontinuousballoondilationgroup,therewere2casesofballoondescendingand4casesof restenosis,withcomplicationsrateof33.3% andrecurrencerateof22.2%.Comparingthecomplication,theballoondilationgroup>thestentimplantationgroup(χ2=0.056,P>0.05),thestentimplantationgroup>thecontinuousballoondilationgroup(χ2=4.243, P<0 .05 ),the balloon dilation group>the continuous balloon dilation group (χ2=5 .743 ,P<0 .05 ).Co m paring the recurrence rate ,the balloondilationgroup>thestentimplantationgroup(χ2=4.033,P<0.05),thestentimplanationgroup>thecontinuousballoondilationgroup (χ2=0.684,P>0.05),theballoondilationgroup>thecontinuousballoondilationgroup(χ2=9.120,P<0.05).Conclusion There aredifferentincidenceofcomplicationsandrecurrenceinthreemethods,andthecontinuousballoondilationissimplerandlesscomplicationsand recurrencethantheothertwomethods.Itcanbethefirstchoiceforinterventionaltreatmentofesophagealstenosis.
ABSTRACT
Objective Toevaluatetheclinicaleffectofinterventionaltreatmentfordelayedhemorrhageinpatientsafterabdominal surgery.Methods Dataof76patients,undergoingangiographyduetodelayedpostoperativehemorrhage,wereanalyzedretrospectively. Theexclusioncriteriaincludedpositiveangiographywithoutembolizationorhaemorrhagecausedbyothercauses(urologicaland reproductivesystemdiseases).Basedonendovascularprocedures,thepatientsweredividedintoembolizedgroup (positiveangiography withembolization)andnon-embolizedgroup(negativeangiographywithoutembolization).Theoutcomesoftreatmentwerecompared betweentwogroupsandfactorsassociatedwithrebleedingwerealsoanalyzed.Results Angiogramswerepositivein70% (53/76)of patients,andintravascularembolizationswereperformed.Intheembolizationgroup,technicalsuccessrateandclinicalsuccessrate were98.1%(52/53)and71.7%(38/53),respectively.Noseverecomplications,suchasgastrointestinalorhepaticischemicnecrosis wereobservedinallpatients.Therebleedingrateswere28.3%and52.2%intheembolizationgroupandthenon-embolizationgroup, respectively(P＝0.046).Multivariateanalysisshowedthatuseofvasopressoragentsbeforesurgerywasanindependentriskfactor forrebleeding (P＝0.022).Conclusion Intravascularinterventionaltherapyisasafeandeffectivemethodfordelayedhemorrhageafter abdominalsurgery.Useofvasopressoragentsbeforesurgerymayincreasetheriskofpostoperativerebleeding.