小探头超声内镜诊断贲门失驰缓症12例临床分析

Clinical analysis of endoscopic miniprobe ultrasonography in the diagnosis of achalasia of cardia

目的探讨小探头超声内镜在诊断贲门失驰缓症中的临床价值。方法对我院2008年9月至2011年9月间收治的12例经常规食管吞钡或者上消化道钡餐造影检查提示为贲门失驰缓症的患者(A组),及30例无吞咽困难等贲门疾患的患者(B组)均行小探头超声内镜检查,了解其胃镜图像、贲门处管壁厚度、固有肌层厚度及有无异常回声。结果 A组胃镜图像显示食管不同程度扩张,内容物滞留,贲门口强力收缩狭窄呈玫瑰花样,小探头超声内镜示贲门处层次结构清楚,无异常回声,管壁厚度平均4.9cm,固有肌层厚度3.4mm。A组管壁厚度与固有肌层厚度分别为(4.9±0.5)mm和(3.4±0.2)mm,B组分别为(3.3±0.3)mm和(2.1±0.2)mm,两组比较差异具有统计学意义(P<0.05,P<0.01)。结论小探头超声内镜能清楚显示消化道壁的层次及结构,与胃镜图像结合可作为贲门失驰缓症确诊的最佳检查方法。

Objective To evaluate the diagnostic value of endoscopic miniprobe ultrasonography（MPS） in achalasia of cardia（AC）.Methods Twelve patients with diagnosed AC by upper gastrointestinal barium-meal examination（Group A） and 30 patients with cardiac disease without dysphagia（Group B） were examined by MPS from September 2008 to September 2011.The gastroscopy,the thickness of cardia wall,and muscularis propria were compared between the two groups.Results The gastroscopy of group A displayed expansion of the esophagus,retention of the contents,and cardiac ostium stenosis like the rose.The thickness of cardia wall and muscularis propria were（4.9±0.5） mm and（3.4±0.2） mm in Group A,and（3.3±0.3） mm and（2.1±0.2） mm in group B,respectively.There were statistically significant difference between the two groups（P〈0.05,P〈0.01）.Conclusion MPS combined with gastroscope are the best examining method for diagnosing AC.