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目的 :探讨下咽食管狭窄的重建术 ,以取得更好的治疗效果。方法 :总结 35例下咽食管狭窄患者的治疗方法 ,包括类固醇激素和抗生素治疗、扩张治疗、下咽食管成形术 (胸大肌肌皮瓣、胸三角肌皮瓣、胸锁乳突肌皮瓣、全厚皮片、结肠上徙、胃上提、游离空肠、瘢痕切除局部粘膜减张缝合或纵切横缝 )。结果 :35例中 ,33例治愈 ,恢复正常饮食。经 1～ 19年的随访治愈病例未出现狭窄复发 ,疗效巩固。结论 :早期轻度的下咽食管狭窄可采用类固醇激素加抗生素治疗和扩张治疗 ,严重的下咽食管狭窄需行下咽食管成形术 ,局限于下咽部的狭窄在瘢痕切除后以胸大肌肌皮瓣或局部粘膜的纵切横缝整复 ,合并有食管狭窄者可以结肠上徙代食管术。胸大肌肌皮瓣和结肠不易感染坏死 ,手术成功率高 ,功能恢复满意 ,是下咽食管狭窄较好的修复材料
Objective: To investigate the reconstruction of hypopharyngeal esophageal stenosis in order to obtain a better therapeutic effect. Methods: To summarize the treatment of 35 cases of esophageal sphincter esophageal stricture, including steroid and antibiotic therapy, dilatation therapy, hypopharyngeal esophagoplasty (pectoralis major myocutaneous flap, thoracic triangle myocutaneous flap, sternocleidomastoid flap , Full-thickness skin graft, colon migration, gastric mention, free jejunum, scar removal of local mucosal sutures or longitudinal slit transverse seam). Results: In 35 cases, 33 cases were cured and returned to normal diet. After 1 to 19 years of follow-up cure cases did not appear stenosis recurrence, the effect of consolidation. Conclusion: Early mild hypopharyngeal esophageal stenosis can be treated with steroids and antibiotics and dilatation therapy. Severe hypopharyngeal esophageal stenosis requires pharyngeal esophagectomy limited to the hypopharyngeal stenosis after excision of the scar to the pectoralis major Myocutaneous flap or local mucosal longitudinal incision and intertrochanteric consolidation of esophageal stenosis who colon esophageal surgery. Pectoralis major myocutaneous flap and the colon is not easy to infection necrosis, high success rate of surgery, functional recovery satisfaction, is a good repair of theopharyngeal esophageal stenosis material