A型肉毒毒素治疗贲门失弛缓及远期疗效观察

Long-term results of endoscopic injection of botulinum toxin in achalasic patients

目的 评价内镜下注射肉毒毒素治疗贲门失弛缓的临床效果。方法 对 57例贲门失弛缓病人采用内镜下注射 A型肉毒毒素治疗，通过对治疗前后主要症状评分及食管下括约肌压力（ LESP）测定评价近期疗效。治疗后半年、 1年、 2年随访，评价中远期疗效。结果 在 57例病人中有 54例治疗后症状缓解占 95％，无合并症发生。随访观察治疗后半年以上有 41例，其中 36例未复发占 88％； 1年以上 30例，有 25例未复发占 83％； 2年以上 12例，有 8例未复发占 67％。结论 内镜下注射 A型肉毒毒素治疗贲门失弛缓是一简单、安全、有效的方法。

Objective To evaluate the clinical efficacy of endoscopic injection of botulinum toxin. Methods A total of 57 achalasia patients were treated with endoscopic injection of 80U of botulinum toxin into the gastric cardia. Symptom score was given to each patient, and the lower esophageal sphincter (LES) pressure was measured before and after treatment. The patients were followed to evaluate the long term efficacy. Results 54/57 patients (95％ ) developed a symptomatic relief. 36/41 (88％ ), 25/30 (83％ )) and 8/12 (67％ ) patients were still in clinical remission after 6, 12 and 24 months follow-up respectively. Conclusion Endoscopic botulinum toxin injection appeared to be a very safe, effective and promising therapy for achalasia.