大直径球囊治疗贲门失驰缓症  

Large-diameter balloon dilation in the treatment of esophageal achalasia

作　　者：周顺科[1] 张子曙[1] 朱晖[1] 谭利华[1] 沈树斌[1] 杨树仁[1] 肖恩华[1] 伍玉枝[1] 朱美香[1] 

机构地区：[1]中南大学湘雅二医院放射科,长沙410011

出　　处：《湖南医科大学学报》2002年第6期559-562,共4页Bulletin of Hunan Medical University

摘　　要：目的 :探讨Boston大直径专用贲门扩张球囊治疗贲门失弛缓症的方法及其疗效。方法 :在电视透视监视下 ,经口腔途径置入超滑导丝和Wilson Cook公司的食管通条预扩张 ,将Boston专用贲门扩张球囊送至贲门狭窄部 ,采用“逐级膨胀 ,突然减压”法进行扩张。球囊达最大直径时 ,反复 3～ 5次 ,最多者达 8次。结果 :食管通条及球囊放置成功率 10 0 % ,所有病例一次性置管扩张成功 ,2例食管破裂 ,经保守治疗治愈。术后随访 1～ 38月 ,无 1例复发 ,吞咽困难缓解率 10 0 %。 15 2例进食感觉完全正常。结论 :采用Boston大直径专用贲门扩张球囊 ,施用“逐级膨胀 ,突然减压”充盈球囊治疗贲门失弛缓症是简单而有效的方法 。Objective To evaluate the effectiveness and method of the large diameter balloon dilation in the treatment of esophageal achalasia. Methods The hydrophilic guide wire and Wilson Cook's Savary Gilliard dilators were inserted into the stomach through the oral cavity under fluoroscopy. The Boston's balloon (35 mm in diameter) was introduced to the stricture site at the cardia through the guide wire and was inflated by the pressure pump (maximum pressure 15 PSI) with the method of 'graded intermittent inflation'. The balloon was inflated again to the maximum diameter for 3～5 times with the maximum of 8 times. Results The insertion of the Savary Gilliard dilators and the Boston's balloon were technically successful in all the 204 patients. The cardia regions of the esophagus was ruptured and cured with conservative treatment in 2 patients. The follow up time was 1～38 months (mean 18.5 months). Recurrent stenosis did not occur in any patient. The remission rate of dysphagia was 100%. The swallowing function was absolutely normal in 152 of the 204 patients (74.5%). Conclusion The Boston's balloon dilatation is simple and effective in the treatment of esophageal achalasia. It is considered to be an alternative to surgical procedures.

关 键 词：贲门失驰缓症 介入治疗 球囊扩张 疗效 电视透视 

分 类 号：R573.7[医药卫生—消化系统] R815[医药卫生—内科学]