超声内镜下注射A型肉毒毒素治疗贲门失弛症的临床研究  

THE TREATMENT OF ACHALASIA BY INJECTION OF BOTULINUM TOXIN UNDER ENDOSCOPIC ULTRASOUND ASSISTANCE

作　　者：刘庆森[1] 蔡逢春[1] 郭荣斌[1] 孟江云[1] 程留芳[1] 程凤歧[1] 黎力[1] 

机构地区：[1]解放军总医院

出　　处：《解放军医学杂志》1999年第2期115-116,共2页Medical Journal of Chinese People's Liberation Army

摘　　要：对１０例经上消化道钡餐、内镜和食管动力检测确诊为贲门失弛症的病人，在超声内镜辅助下于食管下段扩约肌（ＬＥＳ）分４点注射Ａ型肉毒毒素８０Ｕ（每点２０Ｕ），对治疗前后主要症状打分，测定治疗前后食管下段扩约肌压力（ＬＥＳＰ），进行统计学分析，以评价其疗效。治疗前病人主要症状打分为６．１０±２．０２；治疗后为１．３０±１．２７，差异有显著性意义（Ｐ＜０．０１）。ＬＥＳＰ治疗前为（５．０５±１．５６）ｋＰａ，治疗后为（３．３６±１．５１）ｋＰａ，差异有显著性意义（Ｐ＜０．０１）。无明显的不良反应和合并症发生。超声内镜下注射肉毒毒素治疗贲门失弛症为一简单、安全、有效的方法。To test the hypothesis that injection of botulinum toxin under endoscopic ultrasound assistance may effectively reduce the occurrence of spasm at gastric cardia, and to offer an effective treatment for achalasia, 10 patients with achalasia were confirmed by exclusion of secondary causes by routine upper endoscopy and barium meal, were enrolled for study. The lower esophageal sphincter (LES) was identified as a thickened hypoechoic zone. A total of four 1 ml injections (80U) of botulinum toxin were made in different quadrants of the LES in each patient. A dysphagia score, which was the sum of the individual scores of dysphagia, regurgitation and chest pain, was given to each patient, and LES pressure was measured before and after treatment. The results showed that LES pressure (5.05±11.56 kPa vs 3.36±1.51 kPa) and dysphagia score (6.10±2.02 vs 1.30±1.27) were decreased significantly (both P <0.01) after the treatment. The botulinum toxin injection with the assistance of endoscopic ultrasound appeared to be a very safe, effective and promising alternative for the currently available therapeutic tools for achalasia.

关 键 词：贲门失驰症 EUS 注射疗法 A型肉毒素 

分 类 号：R573.705[医药卫生—消化系统] R996.1[医药卫生—内科学]