内镜下大直径球囊扩张术治疗贲门失弛缓症的疗效评价

The therapeutic evaluation of endoscopic large-dimaeter for achalasia of cardia

目的：探讨内镜下大直径球囊扩张术治疗贲门失弛缓症的方法及疗效。方法内径下大直径球囊扩术治疗22例贲门失弛缓症患者，观察其临床症状，复查胃镜或X线，以了解其疗效。结果22例患者吞咽困难缓解率100%，其中一次操作成功率95.5%（21/22），两次扩张（1例先行沙氏条预扩）成功率4.5%（1/22）。术后出血行手术治疗1例，出现皮下气肿、纵膈气肿1例，经内科治疗后痊愈。复查胃镜或X线均较扩张前明显改善。随访3个月～2年，无一例复发。结论内镜下球囊扩张术是目前基层医院治疗贲门失弛缓症的较为理想的首选和主要治疗方法，其具有疗效确切、操作简单、费用低及痛苦小等优点。

Objective To investigate the efficacy of endoscopic large-diameter balloon dilation in the treatment of achalasia of cardia. Methods A total of 22 patients with achalasia of cardia were treated with endoscopic large-diameter balloon dilation. Then the clinic symptoms were observed, and gastroscopy or X-ray examination were performed to evaluate the therapeutic efficacy. Results The remission rate for dysphagia was 100%. The success of signal and twice manipulations was 95.5%（21/22） and 4.5%（1/22）, respectively. Massive hemorrhage of the cardia region was seen in one patient ,and surgical repair had to be carried out. Subcutaneous emphysema and meddiastinal emphysema occurred in one patient, but cured after treatment. The reexamination of gastroscopy or X-ray indicated that the symptoms were improved obviously in camparison with those before endoscopic balloon dilation treatment. After following up for about 0.25 and 2 years, no one recurred. Conclusion For the treatment of achalasia of cardia, balloon dilatation is effective, techhnically-simple, economical and minimally-invasive. This technique should be regarded as the treatment of ideal and first choice for patients in primary hospital.