胃镜引导结合X线透视下气囊扩张治疗贲门失弛缓症72例临床分析

Endoscopic balloon dilatation with x-ray guidance for treatment of achalasia: a clinical analysis of 72 patients

目的:探讨胃镜引导结合X线透视下气囊扩张治疗贲门失弛缓症(AC)的疗效及安全性。方法:对72例AC患者行经胃镜引导结合X线透视下气囊扩张治疗,观察临床疗效、术中及术后并发症发生情况。结果:72例AC患者行贲门气囊扩张74次,显效71例(99%),1例穿孔(1%),65例(90%)术中出现不同程度的胸骨后疼痛,63例(88%)术后胃镜见不同程度贲门撕裂,撕裂1～4处,平均1.6处,18例(25%)出现撕裂处少许渗血,无一例出现术中及术后大出血。结论:胃镜引导结合X线透视下气囊扩张治疗AC疗效好,安全性高,是AC的首选及理想的治疗方法。

Objective： To evaluate the efficacy and safety of endoscopic pneumatic dilation in the treatment of achalasia with X-ray fluoroscopy guidance.Methods： Seventy-two patients underwent endoscopic pneumatic dilation combined with X-ray fluoroscopy guidance.Therapeutic efficacy and intraoperative and postoperative complications were recorded for analysis.Results： Total 74 endoscopic pneumatic dilation were performed on 72 patients,with complete response in 71 cases（99%）,except for 1 case（1%） complicated by perforation.Various degrees of chest pain were observed in 65 cases（90%）.Cardia tears were revealed in 63 cases（88%） at different levels after surgery,with 1 to 4 tears（mean 1.6 tears）.Among them,tear bleeding was found in 18 cases（25%）.No massive upper gastrointestinal bleeding or other complications occurred.Conclusion： Endoscopic pnenumatic dilation combined with X-ray fluoroscopy is effective and safe to treat achalasia.