探讨透视下球囊扩张术治疗婴幼儿食管良性狭窄的临床疗效及安全性。

回顾性分析我院2007年7月至2015年12月收治的53例食管良性狭窄患儿（其中食管腐蚀性狭窄组14例，食管闭锁术后吻合口狭窄组39例）的临床资料，所有患儿经X线钡餐造影确诊后，在影像引导下进行食管狭窄的球囊扩张治疗，比较两组术中的扩张效果。术后随访6~18个月，观察并比较两组疗效。

53例患儿共进行187次球囊扩张术，平均每个患儿扩张3.5次（范围1~11次），球囊直径范围为6~20 mm。食管腐蚀性狭窄组患儿均需经过两次及以上扩张，扩张成功14例（100%）。食管吻合口狭窄组患儿中，1次扩张成功11例（28.2%），两次及以上扩张成功28例（71.8%）。两组的扩张次数差异无统计学意义（P>0.05）。术后行X线钡餐造影示食道狭窄段较前显著扩张，造影剂通过顺利，达到治愈标准，扩张成功率为100%。所有患儿术后随访6~18个月，总有效率（79.2%，42/53），吻合口狭窄组患儿FBD治疗有效率（87.1%，34/39）高于腐蚀性狭窄组（57.1%，8/14），差异有统计学意义（χ²=3.972，P<0.05）。

透视下球囊扩张术治疗婴幼儿食管良性狭窄临床疗效显著，特别对于食管闭锁术后吻合口狭窄的患儿，安全性好，且易操作，临床应用和推广价值高。

To evaluate the effectiveness and safety of fluoroscopic balloon dilatation (FBD) in infants and children with esophageal benign stricture.

The medical records of 53 children (14 cases with corrosive esophagostenosis and 39 cases with anastomotic stricture following repair of esophageal atresia) diagnosed with esophageal stricture and required FBD therapy from July 2007 to December 2015 in our hospital were retrospectively reviewed. All procedures for balloon catheter dilation treatments were performed under general anesthesia using fluoroscopic guidance. The dilation effects during operation were compared. The clinical effectiveness was analyzed during the 6-18 months post-operation follow-up.

A total of 187 FBD sessions (median, 3.5 dilations per patient; range, 1-11 dilations) were performed in 53 patients. The balloon catheter diameters ranged from 6 to 20 mm. Patients with corrosive esophagostenosis required two or more dilations, all 14 patients (100%) were successfully dilated. Eleven out of 39 (28.2%) patients with anastomotic stricture were successfully dilated for one dilation, and the rest (71.8%) were successfully dilated for two or more dilations. There was no statistical difference in the times of dilation between the two groups (P>0.05) . The X-ray barium meal contrast examination showed an obvious expansion of esophageal stricture after operation, and the contrast agent successfully passed through the narrow location. The outcome of treatment reached the curative criterion and the success rate of balloon dilatation was 100%. During the 6-18 months follow-up, the total effective rate of FBD treatment was 79.2% (42/53) . The effective rate of patients with anastomotic stricture (87.1%, 34/39) was significantly higher than patients with corrosive esophagostenosis (57.1%, 8/14) . There was statistical difference in effective rate between the two groups (χ²=3.972, P<0.05) .

Fluoroscopically guided esophageal balloon dilatation with remarkable curative effect could be considered to be the first option for management of esophageal benign stricture, especially for anastomotic stricture following repair of esophageal atresia. The treatment is safe and easy for operating, and is worth of clinical application and popularizing.