气囊扩张术治疗食管贲门失弛缓症105例临床分析

Clinical Analysis of Pneumatic Dilation in 105 Cases with Achalasia

目的:观察气囊扩张术治疗食管贲门失弛缓症的疗效。方法:华西医大附一院收治的食管贲门失弛缓症病人105例,其中男性56例(53％),女性49例(47％),平均年龄34.2岁。主要临床症状为吞咽困难,食物反流,胸痛及体重减轻等。通过临床表现,X线钡餐可明确诊断。气囊经胃镜下导丝置人,压力5-10 PSI,维持30-60 s。间隔2-3min后再扩张共2-3次。结果:105例病人显效95例(90.3％),有效10例(9.6％),无效0例。术后无1例穿孔,其他并发症轻。复发后重复扩张仍有效,较肉毒杆菌毒素注射及Hellsr’s肌切开术有更多优越性。结论:气囊扩张术为治疗贲门失弛缓症的首选方法。

Objective:To evaluate the effect of pneumatic dilation for achalasia. Methods: 105 cases with achalasia in the first affilicated hospital, from 1997 to 2001(56 males,49 females, average age 34.2 years)were observed. Their main symptoms were dysphagia, regurgitation of food, chest pain, weight loss and so on. The diagnosis was identified by clinical symptoms and barium meal. Ballonet was put into by lead filum under gastroscope,maintained 5 - 10 PSI and 30-60s, dilated again after 2 - 3 min, repeated 2 - 3 times. Results: In all cases, 95(90.3%) were improved, 10(9.6%) wer effective and 0 was ineffective. There were no perforation after pneumatic dilation and other complications were mild. In relapse case, repeated dilation was still effective. Pneumatic dilation was superior to botulinum toxin injections and Heller's myotomy. Conclusion:Pneumatic dilation was the superior treatment method for achalasia