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

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 手术成功率为97.8%(44/45)，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。

Abstract:

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.