目的 观察数字减影血管造影（DSA）引导梯度压力法分阶段球囊扩张对食管癌吻合口狭窄 患者的治疗效果以及对营养指标的影响。方法 选取我院 2020 年 8 月至 2022 年 8 月收治的 120 例食管癌 吻合口狭窄患者，将行内镜下梯度压力法分阶段球囊扩张法治疗的 57 例患者纳入对照组，将行 DSA 引导 梯度压力法分阶段球囊扩张法治疗的 63 例患者纳入观察组。比较两组患者术后食管狭窄治疗总有效 率、扩张次数、并发症情况，比较两组患者手术前后吞咽功能、吻合口狭窄部直径、生活质量评分、营养指 标。结果 观察组患者治疗总有效率 98.41%显著高于对照组的 89.47%（P = 0.037），观察组患者扩张次数 显著低于对照组（P < 0.001）；术后两组患者吞咽功能评分较术前降低，且观察组患者吞咽功能评分显著 低于对照组（P < 0.001），两组术后吻合口狭窄部直径比术前升高且观察组显著高于对照组（P < 0.001）； 观察组术后出血发生率20.63%，显著低于对照组的47.37%（P = 0.002），两组患者术后1个月生活质量评分 较术前均升高，且观察组患者术后 1 个月情绪功能、社会功能评分显著高于对照组（P = 0.015，P = 0.016）； 术后两组患者血清视黄醇结合蛋白（RBP）、血红蛋白（Hb）、转铁蛋白（TF）均升高，且观察组患者显著高 于对照组（P < 0.001），观察组术后白蛋白（ALB）比术前升高（P < 0.05），术后观察组 ALB 显著高于对照组 （P = 0.045）。结论 DSA 引导梯度压力法分阶段球囊扩张对食管癌吻合口狭窄的治疗效果更好，患者营 养指标水平更高，值得在临床上推广使用。 

Objective To observe the therapeutic effect of digital subtraction angiography（DSA）guided gradient pressuring by staged balloon dilation on anastomotic stenosis.in patients with esophageal cancer. Methods Totally，120 patients with anastomotic stenosis admitted to our hospital from August 2020 to August 2022 were enrolled in the study. Fifty ⁃seven of them treated with endoscopic gradient pressuring by staged balloon dilatation were set as the control group，and the other 63 ones treated with DSA guided gradient pressuring with staged balloon dilatation were set as the observation group. The two groups were compared in terms of total response rate， dilation times，and complications of postoperative esophageal stenosis，swallowing function，anastomotic stenosis diameter，quality of life score，and nutritional index before and after surgery. Results The total response rate in the observation group and the control group was 98.41% and 89.47%，respectively，with significant difference between them（P = 0.037），The number of expansion in the observation group was significantly lower than that in the control group（P < 0.001）. Reduclower swallowing function scores in both groups were significantly lower as compared with preoperative swallowing function and the score of the observation group was significantly lower than that of the control group after operation（P < 0.001）. The diameters of anastomotic stenosis in both groups after operation were significantly increased as compared to the preoperative，and that of the observation group was significantly larger than that of the control group after operation（P < 0.001）. The incidence of postoperative bleeding in the observation group was significantly lower than that in the control group（20.63% vs. 47.37%，P = 0.002）. The scores of QOL in both groups were elevated one month after surgery as compared with the preoperative and the scores of emotional function and social function in the observation group were significantly higher than those of the control group（P = 0.015，0.016）. After surgery，the levels of serum retinol⁃binding protein（RBP），hemoglobin（Hb）and transferrin （TF）were all increased in both groups，and the levels in the observation group were significantly higher than those in the control group（P < 0.001）. The postoperative level of ALB was significantly higher than the preoperative one in the observation group（P < 0.05）and after operation，the level of ALB in the postoperative observation group was significantly higher than that in the control group（P = 0.045）. Conclusion DSA guided gradient pressuring with staged balloon dilation has better therapeutic effect on anastomotic stenosis in esophageal cancer patients and the nutritional index level in the patients is higher，thereby deserving clinical spreading.