内镜下氩离子凝固术治疗食管贲门失弛缓症疗效观察

Clinical Effect of the Argon Plasma Coagulation in Endoscopic Treatment of Esophageal Achalasia

目的：探讨氩离子凝固术治疗贲门失弛缓症的疗效。方法：选择2010年1月至2012年1月经食道吞钡及内镜检查诊断的贲门失弛缓症12例患者进行内镜下环行点状治疗后临床观察,治疗单次启动延续时间1～3 s,启动次数视局部组织凝固的深度而定,一般环行凝固4个点,深度0.2~0.3 cm为宜,术中局部喷1∶5去甲肾上腺素盐水10 mL,术后加用止血及抗感染药物及进流质饮食3 d,观察1周出院,所有病例1~3月内复查食道吞钡及胃镜检查。结果：12例患者中2例失访,其余10例患者均复查,临床症状消失,食道吞钡、胃镜下未见复发。结论：氩离子凝固术治疗是治疗贲门失弛缓症的新方法,操作方便,疗效较好,值得推广应用。

Objective： To explore the treatment effect of the argon plasma coagulation （APC） in the endoscopic treatment of esophageal achalasia. Methods： Twelve patients diagnosed as achalasia with barium meal and endoscopy from Jan 2010 to Jan 2012 were treated with APC. The single operating interval time was 1-3 seconds,treatment numbers were dependent on the depth of the partial tissue coagulation （general chosed 4 ring coagulation points, appropriate depth of 0.2-0.3 cm, 10 mL of 1：5 norepinephrine saline was applied intra-operatively）. Patients were then treated with pharmacological hematischesis and anti-infection therapy, as well as the liquid diet for 3 days postoperatively. Patients left hospital after 7-days observation. All the cases were followed up by barium meal and endoscopy examination in 1-3 months after APC. Results Two cases were lost in 12 patients, the other 10 patients, whose clinical symptoms were disappeared, were not found esophageal achalasia recurrence by barium meal and endoscopy. Conclusion： APC is a new technique and it is an effective and convenient method in esophageal achalasia treatment, which should be widely applied.