胃镜下探条或自制气囊扩张治疗贲门失弛缓症疗效的对比研究

目的对比分析胃镜下应用探条或自制气囊扩张治疗贲门失弛缓症的疗效。方法1998年1月～2007年12月，胃镜下治疗贲门失弛缓症45例，其中应用自制气囊扩张22例（自制气囊组），应用探条扩张23例（探条组），比较2组疗效。结果探条组23例扩张1～9次，平均3．6次；自制气囊组22例扩张1～6次，平均2．3次。2组术中及术后均无并发症发生。首次治疗费用探条组（1542．57±281．30）元，自制气囊组（861．91±176．48）元（t=9．671，P=0．000）。扩张后3个月的疗效2组差异无显著性探条组显效14例（61％）、有效8例（35％）、无效1例（4％），自制气囊组显效15例（68％）、有效5例（23％）、无效2例（9％），Z=-0．351，P=0．726]。扩张后6个月的疗效2组差异有显著性探条组显效5例（22％）、有效3例（13％）、无效15例（65％），自制气囊组显效10例（45％）、有效7例（32％）、无效5例（23％），Z=2．564，P=0．010]。结论胃镜下应用探条和自制气囊扩张治疗贲门失弛缓症安全、简便，患者恢复快，尤其自制气囊扩张器设备简单，就地取材，疗效肯定，在基层医院具有良好的推广价值。

Comparison between Endoscopic Probe and Self made Balloon Device for Cardia Achalasia

Objective To compare the effects of endoscopic probe and self-made balloon device in dilation of the cardia for patients with cardia achalasia. Methods From January 1998 to December 2007, 45 patients with cardia achalasia received gastroscopy-assisted dilation at our hospital ; 22 of them were treated by self-made balloon device and 23 were by endoscopic probe. The efficacies of the two methods were compared. Results In the probe group, each patients received 1 to 9 times of dilation （mean, 3.6） , while in the balloon group it was 1 to 6 times （ mean, 2.3 ）. None of the two groups had intra- and post-operative complications. The cost for the first treatment was （ 1542.57 ± 281.30） yuan in probe group, and （ 861.91 ± 176.48） yuan in the balloon group （ t = 9. 671, P = 0. 000）. The efficacy of the two groups was similar in 3 months after the treatment the rates of the cured, improved, and failed were 61% （14）, 35% （8）, and 4% （1） in the probe group, and 68% （15）, 23% （5）, and 9% （2） in the balloon group, Z= -0.351, P=0.726], but significantly different in6 months 22% （5）, 13% （3）, and 65% （15） vs45% （10）, 32% （7）, and 23% （5）, Z = 2. 564, P = 0. 010]. Conclusions Both endoscopic probe and self-made balloon device are effective in dilatation of the cardia for cardia achalasia. Self-made balloon device dilatation is exceptionally suitable for local hospitals because of its low cost and simple techniques.