暂时性金属支架扩张术治疗贲门失弛缓症对食管动力中远期的影响  

Long-term effects of achalasia on esophageal motility following temporary internal metal stent dilation

作　　者：陈尼维[1] 朱金水[1] 陈维雄[1] 孙群[1] 王如华[1] 

机构地区：[1]上海交通大学附属第六人民医院消化科,上海市200233

出　　处：《世界华人消化杂志》2007年第25期2723-2725,共3页World Chinese Journal of Digestology

摘　　要：目的:探讨暂时性金属支架治疗贲门失弛缓症对食管动力中远期的影响.方法:19例贲门失弛缓症患者在X线下置入国产可扩张带膜金属支架,术后3-7d由胃镜取出.治疗前、后2wk及2a测定LES静息压、松弛率、食管内24h pH监测,12例健康人测定下食管括约肌(LES)静息压、松弛率.结果:扩张后2wk和2a LES静息压显著低于扩张前LES静息压(12.32±5.87 mmHg,14.21±7.34 mmHg vs 47.43±9.84 mmHg,P<0.05),松弛率显著高于扩张前松弛率压(76.66%,73.46% vs 13.33%,P<0.05),但他们均与正常人无显著差异.扩张后2a GER阳性率显著高.于扩张后2wk及扩张前(66.12% vs 27.72%,2.95%;P<0.01).结论:中远期暂时性金属支架扩张术仍能显著降低贲门失弛缓症患者的LES压力.但GER也显著增加.AIM： To explore the long term effects of achalasia on esophageal motility following temporary internal metal stent dilation. METHODS： Nineteen patients with achalasia had temporary internal metal stents （20-25 mm diameter） placed under X-ray guidance. After stent dilation over 3-7 days, the stents were removed by endoscopy. We measured lower esophageal sphincter （LES） pressure, LES relaxation rate, and 24-hours pH in the 19 patients and 12 healthy control subjects （HS）. RESULTS： LES residual pressure before stent dilation was markedly higher than at 2 weeks and 2 years after stent dilation （47.43 ± 9,84 mmHg vs 12.32 ± 5.87 mmHg, and 14.21 ± 7.34 mmHg; P 〈 0.05）. LES relaxation rate was significantly different before stent dilation that at 2 weeks and 2 years after （13.33% vs 76.66%, and 73.46%, P 〈 0.05）. The frequency of gastroesophageal reflux （GER） at 2 years after stent dilation was markedly higher than before and two weeks and before stent dilation （66.12% vs 27.72%, 2.95%, P 〈 0.01）; residual pressure and relax rate showed no significant difference between HS and after stent dilation of 2 weeks and 2 years. CONCLUSION： Temporary internal metal stent dilation results in lower LES pressure and a higher rate of GER for patients with achalasia in the long term.

关 键 词：贲门失弛缓症 暂时性支架 食管动力 

分 类 号：R571[医药卫生—消化系统]