Rigiflex气囊扩张治疗贲门失驰缓症复发患者的临床应用价值  

Clinical application value of large diameter balloon catheter sequential endoscopic pneumatic dilation for recurrent achalasia

作　　者：杨正武[1] 邵先玉[1] 

机构地区：[1]泰山医学院附属医院消化内科,山东泰安271000

出　　处：《中华消化病与影像杂志（电子版）》2013年第4期17-21,共5页Chinese Journal of Digestion and Medical Imageology(Electronic Edition)

摘　　要：目的探讨Rigiflex气囊扩张治疗贲门失弛缓症复发患者的疗效及安全性。方法2000至2012年泰山医学院附属医院27例首次气囊扩张治疗术后复发的贲门失弛缓症患者再次应用直径为3.5 cm的Rigiflex气囊扩张治疗(Rigiflex气囊组),治疗后1、3、6、12、24、36个月随访患者临床症状积分、食管钡透检查、并发症情况等,并与43例首次接受3.2 cm直径哑铃型气囊扩张治疗患者(哑铃型气囊组)进行对照。Rigiflex气囊组与哑铃型气囊组患者治疗有效率比较采用χ2检验。Rigiflex气囊组与哑铃型气囊组患者治疗前、后贲门口直径、5 min存留钡柱高度比较采用t检验。结果 Rigiflex气囊组患者治疗后6、12、24、36个月的治疗有效率分别为81.5%、77.8%、70.4%、51.9%,均高于哑铃型气囊组患者的65.1%、39.5%、27.9%、18.6%,且差异均有统计学意义(χ2值分别为2.18、93.77、12.12、8.51,均P<0.05)。Rigiflex气囊组患者治疗后1、3、6、12、24、36个月贲门口直径均大于哑铃型气囊组患者,5 min存留钡柱高度均低于哑铃型气囊扩张组患者,且差异均有统计学意义(贲门口直径:t值分别为2.96、14.69、20.96、17.24、9.70、8.09;5 min存留钡柱高度:t值分别为2.77、3.85、4.96、6.25、7.78、6.38;P<0.05或0.01)。2组患者均未发现食管大出血及穿孔等并发症发生。结论选择3.5 cm直径的大口径Rigiflex气囊序贯扩张治疗复发的贲门失缓症患者长期疗效显著,效价比突出,治疗安全性高。Objective To evaluate the efficacy and safety of Rigiflex balloon catheter in the treatment of patients with recurrent achalasia. Methods In Rigiflex balloon group,twenty-seven patients with recurrent achalasia from 2000 to 2012 in Affiliated Hospital of Taishan Medical College were treated using Rigiflex balloon catheter（ diameter 3. 5 cm）,clinical symptom scores,esophageal barium meal X-ray examinations and complications were followed up 1 month and 3,6,12,24,36 months after treatment. In control group,43 cases accepted the diameter 3. 2 cm dumbbell-shaped balloon dilatation treatment for the first time（ dumbbell-shaped balloon group）. The effective rates of the two groups were compared with χ^2test,the diameters of cardiac ostium and the heights of barium column after 5 min before and after treatment were compared with t test. Results The effective rates of patients in Rigiflex balloon group were 81. 5%,77. 8%,70. 4% and 51. 9% after treatment for 6, 12, 24 and 36 months, higher than those of dumbbell-shaped balloon group（ 65. 1%,39. 5%,27. 9% and 18. 6%,respectively）,and the differences were statistically significant（ χ^2= 2. 18,93. 77,12. 12,8. 51,all P〈 0.05）. The cardiac ostium diameters of Rigiflex balloon group 1,3,6,12,24 and 36 months after treatment were all greater than those of dumbbell-shaped balloon group（ t = 2. 96,14. 69,20. 96,17. 24,9. 70,8. 09,P〈 0.05 or 0. 01）,the heights of barium column after 5 min of Rigiflex balloon group were all higher than those of dumbbell-shaped balloon group（ t = 2. 77,3. 85,4. 96,6. 25,7. 78,6. 38,P〈 0.05 or 0. 01）,and the differences were statistically significant. Complications such as esophageal bleeding,perforation were not found in the two groups. Conclusion Sequential dilation with 3. 5 cm diameter Rigiflex balloon catheter for patients with recurrent achalasia has significant long-term effect,well cost-effect and high security.

关 键 词：食管失弛缓症 复发 气囊扩张术 治疗结果 

分 类 号：R571[医药卫生—消化系统]