囊液递增加暂留支架贲门成形术治疗贲门失弛缓症（附18例报告）  

Sac Liquid Increment plus Staying Stent Cardiac Angioplasty in Treatment of Achalasia of Cardia： 18 Cases Report

作　　者：涂清平[1] 雷泳华[1] 刘国民[1] 黄秋根[1] 

机构地区：[1]丰城市人民医院放射科,江西丰城331100

出　　处：《实用放射学杂志》2011年第4期604-606,共3页Journal of Practical Radiology

摘　　要：目的 探讨贲门失弛缓症介入治疗的方法 及疗效.方法 收集18例贲门失弛缓症病例,做囊液递增贲门导管成形术28次,其中8例1次成功,2例重复1次成功,另 8例重复1次后疗效不佳,再置入支架,暂留1～2月内取出才成功.方法 是将球囊置于贲门,注入20%泛影葡胺液30 ml定位,再递增到50、60、70、80 ml,每递增一次待5～10 min,直至贲门扩张满意为止.结果 18例经此法治疗后,吞咽障碍都得到改善,10例进食顺利,食管管径恢复到25 mm以下,无钡滞留,随访2～8年无复发.另8例做暂留支架贲门成形术,支架位置稳定,无滑脱,随访2～6年进食顺利.并发症有术中疼痛,但均能忍受.术后出血2例,经回放球囊止血成功.返流性食管炎3例,症状轻微,注意软硬饮食调节均能缓解.结论 囊液递增加暂留支架贲门成形术治疗贲门失弛缓症安全、疗效佳、费用低、痛苦少、不易复发,值得推广.Objective To investigate the method and effect in with cardia achalasia underwent cardia angioplasty for 28 times, 8 interventional treatment of achalasia of cardia. Methods 18 cases cases were successful, 2 cases again one time,8 cases underwent twice and fell,who then underwent stent implantation for one--two months and success. The method of sac fluid increment was that the balloons were put at the cardia, 30 ml of 20% meglumine was injected into the sac for location, than increment to 50,60,70,80 ml,after 5--10 min, until expansion the cardiac satisfied. Results The symptoms of the patients improved in 18 cases, deglutition was well in 10 cases,the esophageal diameter return to below 25 mm and without stranded barium, follow-up for 2-8 years there was not recurrence. In the another 8 cases undergone stayed stent cardiac angioplasty, the stents were stabile and no displacement, the deglutition was well follow-up for 2-6 years. The complications included intraoperative pain, postoperative bleeding, reflux esophagitis. Conclusion Sac liquid increment plus staying stent cardiac angioplasty is safe, effective,low cost,less painful and less recurrence for treatment of achalasia of cardia,it should be promoted.

关 键 词：食管 贲门失弛缓症 支架 介入放射学 

分 类 号：R571[医药卫生—消化系统] R815[医药卫生—内科学]