肉毒毒素注射联合球囊扩张治疗贲门失弛缓症的临床价值  

Combination of botulinum toxin local injection and balloon dilation in the treatment of the primary achalasia

作　　者：王运东[1] 韩真[1] 

机构地区：[1]安徽省芜湖市皖南医学院弋矶山医院消化内科,241001

出　　处：《中华消化内镜杂志》2007年第2期106-108,共3页Chinese Journal of Digestive Endoscopy

摘　　要：目的探讨肉毒毒素注射联合球囊扩张术在治疗贲门失弛缓症中的临床价值。方法选取贲门失弛缓症患者35例，分为两组，其中18例行球囊扩张术（扩张组），17例行肉毒毒素注射联合球囊扩张术（联合组）。随访12个月观察临床症状评分，测量食管钡餐摄片的钡柱高及宽。结果两组患者经治疗后临床症状明显改善，在术后1周、3个月两组的临床症状的缓解差异无统计学意义（P〉0．1），术后6、12个月联合治疗的临床症状缓解优于单独球囊扩张组（P〈0．05）。两组治疗后食管钡餐摄片观察均较治疗前明显好转（P〈0．05），术后1周联合组和单纯扩张组间食管排空差异无统计学意义，12个月联合组和单纯扩张组间食管排空差异有统计学意义（P〈0．05）。结论肉毒毒素注射联合球囊扩张可以有效的缓解患者症状，远期疗效优于单独球囊扩张。Objective To evaluate effect of botulinus toxin injection in combination with balloon dilation and solo balloon dilation on the primary achalasia. Methods 35 achalasia patients divided into two groups, 18 cases only with balloon dialation, 17 patients were treated with balloon dilation after injecting botulinum toxin. Symptom scoring were compared at 1 week, 3 months. 6 months and a year after treatment, esophagography was observed at 1 week and 1 year after therapy. Results Symptom scoring was significantly lower after treatment on the both terms, Symptom scoring of both groups revealed no significant difference within 3 months after therapy（P 〉 0. 1 ）, the effective rates in combination group were higher than that in solo balloon dilation group at 6 months after treatment （P 〈 0. 05 ）. High and width of barium column were both grown down after therapy on the both terms （P 〈 0. 05）, it＇s no significant difference at 1 week after therapy, but at 1 year after treatment the volume of barium column in combination group was less than that in the other group （P 〈 0. 05 ）. Conclusion Treatment of balloon dilation after botulinum toxin injection in the primary achalasia is effective and applicable.

关 键 词：贲门失弛症 肉毒杆菌毒素 A型 气囊扩张术 钡餐 

分 类 号：R57[医药卫生—消化系统]