内镜下球囊扩张治疗贲门失弛缓症的中远期随访观察  

Follow-up of endoscopic pneumatic dilation for achalasia of cardia

作　　者：程芃 柏愚[1] 方军[1] 赵胜兵[1] 王树玲[1] 钟政荣[2] 孟祥军[3] 李兆申[1] Cheng Peng;Bai Yu;Fang Jun;Zhao Shengbing;Wang Shuling;Zhong Zhengrong;Meng Xiangjun;Li Zhaoshen(Department of Gastroenterology, Changhai Hospital, Second Military Medical University, Shanghai 200082, Chin)

机构地区：[1]第二军医大学海军军医大学长海医院消化内科,上海200082 [2]上海交通大学医学院附属第九人民医院检验科 [3]上海交通大学医学院附属第九人民医院消化科

出　　处：《中华消化内镜杂志》2018年第4期244-247,共4页Chinese Journal of Digestive Endoscopy

基　　金：安徽省教育厅自然科学研究重大项目（KJ2015ZD31）

摘　　要：目的评价内镜下球囊扩张治疗贲门失弛缓症（AC）的中远期疗效。方法应用内镜下球囊扩张术治疗45例患者，术后随访2—12年，治疗前后行Eckardt评分及Stooler分级，评价扩张治疗的疗效。结果内镜下球囊扩张术手术成功率为97．8％（44／45），症状有效缓解率93．2％（41／44），未发生大量出血、穿孔等严重并发症。术后随访最长至144个月，10例术后超过60个月。术后吞咽困难症状明显缓解（P〈0．01）。术后24个月及60个月的Eckardt评分均较术前有显著降低（P〈0．01），但术后60个月的Eckardt评分较术后24个月有所回升（P〈0．01）。统计分析显示，病程与术后评分呈明显正相关（P〈0．01），与治疗效果呈明显负相关（P〈0．01）。结论内镜下球囊扩张术治疗AC，具有良好的治疗效果，且安全性较高。Objective To evaluate the mid-to-long term therapeutic effect of endoscopic pneumatic dilation for achalasia of cardia （AC）. Methods Endoscopic pneumatic dilation was used in 45 AC patients, with follow-up of 2-12 years. Eckardt score and Stooler grading were used before and after the operation for evaluation of curative effect of dilation. Results The operation success rate was 97.8% （ 44/45 ） and the effective remission rate was 93.2% （41/44）. No massive hemorrhage, perforation or other serious complications occurred. The longest follow-up time was up to 144 months. Ten cases were followed up for over 60 months. Patients＇ symptoms relieved significantly （P〈0.01）. Eckardt scores in 24 months and 60 months after operation significantly decreased compared with those before the operation （P〈0. 01 ）. But Eckardt score in 60 months was higher than that in 24 months （P 〈 0. 01 ）. The length of the disease history was positively related to post-operative scores, and negatively related to efficacy （ P 〈 0. 01 ）. Conclusion Endoscopic balloon dilation is a satisfactory therapy to AC with good efficacy and safety.

关 键 词：食管失弛症 随访研究 内镜下治疗 球囊扩张 

分 类 号：R655.4[医药卫生—外科学]