摘要
目的探讨超声内镜引导注射A型肉毒杆菌毒素治疗食管贲门失弛缓症的应用价值。方法贲门失弛缓症患者28例随机分为内镜组和超声内镜组各14例。前者在内镜直视下食管括约肌(LES)内注射A型肉毒杆菌毒素治疗,后者采用实时超声内镜引导下LES内注射A型肉毒杆菌毒素治疗。在治疗前与治疗后3、6、12个月观察两组患者的临床症状、X线钡餐5 min存留钡柱高度及贲门口直径。结果在治疗后3个月,内镜组和超声内镜组患者有效率比较,差异无统计学意义(P>0.05);但治疗后6个月和12个月时,超声内镜组的有效率高于内镜组,差异均有统计学意义(P<0.05);治疗后3个月两组贲门口直径、5 min存留钡柱高度比较,差异均无统计学意义(P>0.05);治疗后6个月和12个月时,两组贲门口直径、5 min存留钡柱高度比较,差异均有统计学意义(P<0.05)。结论采用实时超声内镜引导下注射A型肉毒杆菌毒素定位更准确,疗效确切,有临床应用价值。
Objective To investigate the effectiveness of intra sphincteric injection of botulinum toxin A guided by ultrasonic endoscope in treating patients with esophageal achalasia.Methods Twenty eight patients with esophageal achalasia were divided randomly into endoscope group and ultrasonic endoscope group.The individuals in endoscope group was treated with injection of botulinum toxin A and the ultrasonic endoscope group was treated with intrasphincteric injection of botulinum toxin A guided by ultrasonic endoscope.Clinical scores,barium column 5 minutes after barium meal and oesophageal sphincter diameter were observed respectively before treatment and three months,six months and twelve months after treatment.Results There were no statistical differences in effectiveness between endoscope group and ultrasonic endoscope group three months after treatment（P〉0.05）.The effective rates were significantly higher in the ultrasonic endoscope group than endoscope group 6 and 12 months after treatment（P〈0.05）.There was a statistical difference in diameter of the oesophageal sphincter and barium column in five minutes between the two groups（P〈0.05）.Conclusion Intra sphincteric injection of botulinum toxin A guided by ultrasonic endoscope in patients with esophageal achalasia was more effective with the advantages of more accurately orientation and less complications.
出处
《中国全科医学》
CAS
CSCD
北大核心
2010年第36期4145-4147,共3页
Chinese General Practice
