Boston专用球囊治疗贲门失弛缓症

Boston's balloon dilatation for treatment of cardiac achalasia

目的 回顾总结Boston贲门扩张专用球囊治疗贲门失弛缓症 2 6例方法与疗效。方法 在电视监视下经口腔程序置入加强导丝和Boston专用球囊至贲门狭窄部 ,狭窄严重者需用 2 0～ 2 5mm球囊预扩张。用注入 15 %造影剂方法 ,循序渐进与间接性扩张。扩至最大直径持续 5min后松解 ,3～5min后再次扩张 ,连续 3～ 4次。结果 2 6例中球囊放置成功率 10 0 % ,1次扩张成功 2 4例 ,2例 2次扩张。术后随访 2周～ 31个月 ,平均 10 .6个月 ,无 1例复发 ,吞咽困难缓解率 10 0 %。 3例轻度食管反流症状。结论 采用Boston直径 40mm专用球囊治疗贲门失弛缓症是简便而有效的方法 ,可以取代外科手术。

Objective To review and summerize effectiveness and method of the Boston's balloon dilation in cardiac achalasia. Methods The intensified guide wire was inserted into stomach through mouth cavity under TV controll. The Boston's balloon was inserted to the cardiac stricture through the guide wire and dilatated with 15% contrast medium with to a maximum diameter for five minutes and then the balloon was dilatated again for 3～5 minutes, all together for 3～4 times. The severe stricture must be pre dilatated with 20～25mm diameter balloon. Results The balloon insertion was technically successful in all 26 patients. The once succese of ballon dilation was achieved in 24 patients and twice in other 2. Follow up time was from 2 weeks to 31 months(mean 10.6 months). Recurrent stenosis had not occurred in all patients. Remission rate of dysphagia was 100%. Esophageal reflux occurred in 3 patients. Conclusions The Boston's balloon dilatation is simple and effective for treatment of cardiac achalasia. The method sometimes may replace surgical procedure.