摘要
目的 :探讨贲门失弛缓症患者在气囊扩张加食管下括约肌 (L ES)内注射肉毒杆菌毒素 (BT)组 (联合组 )和气囊扩张组 (扩张组 )治疗前后食管动力学特征以及与疗效的关系。方法 :贲门失弛缓症患者 30例 ,所有患者根据临床症状、钡餐、内镜和食管测压确诊 ,确诊后联合治疗 14例 ,单纯气囊扩张治疗 16例。监测治疗前、治疗后 3d、3个月及 1年的临床积分及测压指标。结果 :两组患者经治疗后临床症状明显改善 ,且持续 1年。治疗后 3d、3个月和 1年 ,两组 L ES压力 (L ESP)和 L ES松弛率 (L ESR)与治疗前相比 ,均有明显改善 (P<0 .0 5 ) ,联合组 L ESP下降明显 ,较扩张组相差显著 (P<0 .0 5 )。治疗前全部患者食管体部均为非推进性同步收缩波 ,治疗后联合组 1例恢复为推进性收缩波 ,而单纯气囊扩张组无改善。结论 :气囊扩张加L ES内注射 BT联合治疗贲门失弛缓症疗效较好 ,不仅降低 L ESP,而且改善 L ESR,缓解临床症状 ,疗效较单纯气囊扩张治疗为佳。食管测压是主要的随访方法 ,L ESP和 L
Objective: To study the esophageal motility after treated with balloon dilation and botulinum toxin in patients with achalasia. Methods: Among 30 cases of achalasia, 14 patients were treated with botulinum toxin after balloon dilation and 16 patients only with balloon dilation. The esophageal motor function were assumed in all cases. A pneumhydroulic capillary perfusion system with 4 lumen catheter was used to record esophageal manometry through polygraph after over night fasting. The method was applied in all cases before treatment and 3 days, 3 months, and 1 year after treatment. Results: LESP was significantly lower( P <0.05) after treated with botulinum toxin injection and balloon dilation. LESR recovered compared with that before treatment ( P <0.05). The motor patterns of esophageal body were not propgating before treatment, and that of one patient became propgated one year later. Conclusion: The treatment of botulinum toxin intrasphincteric injection after balloon dilation in achalasia is effective and applicable.
出处
《第二军医大学学报》
CAS
CSCD
北大核心
2001年第6期576-578,共3页
Academic Journal of Second Military Medical University
基金
上海市卫生系统百人计划基金资助项目(98BR0 2 6) .
