贲门失弛缓症肉毒毒素注射治疗前后食管动力学的研究

Study of esophageal motility before and after treatment of intrasphincteric injection of botulinum toxin in patients with achalasia

目的探讨贲门失弛缓症患者的食管动力特征及肉毒毒素局部注射治疗后食管动力学的改变。方法28例患者内镜下局部注射肉毒毒素,分别于治疗前、治疗后1周、3个月时测定下食管括约肌的压力(LESP)、松弛率(LESRR)和食管体部的动力。结果治疗前,LESP为(42.68±17.16)mmHg,LESRR(38.69±3.66)%,吞咽时100%患者食管体部为同步收缩,无推进性蠕动波。肉毒毒素注射治疗后1周和3个月时,LESP分别为(23.35±4.86)mmHg和(22.74±4.02)mmHg,LESRR分别为(79.98±4.16)%和(80.48±3.79)%,但吞咽时食管体部的动力无改善。结论内镜下LES内注射肉毒毒素,可减低LESP和提高LESRR。

Objective] To research the charactestics of esophageal motility before treatment and changes of esophageal motility after treatment of intrasphincteric injection of botulinum toxin in patients with achalasia. [Methods] 28 patients were treated with intrasphincteric injection of botulinum toxin, observing oesophageal sphincteric pressure(LESP), low oesophageal sphincteric relax rate(LESRR), oesophageal body vermiculation while swallowing water before treatment and at 1 week, 3 months after treatment. [Results] Before treatment, LESP was (42.68±17.16)mmHg, LESRR (38.69±3.66)%, At 1 week and 3 months after treatment, LESRR were (23.35±4.86)mmHg and (22.74±4.02)mmHg, LESRR were (79.98±4.16)% and (80.48±3.79)%, The movement paterns of esophageal body were synchronous vermiculation and not propgating both before and after treatment. [Conclusions] Treatment of intrasphincteric injection of botulinum toxin in patients with achalasia can lower LESP and recover LESRR.