大直径球囊治疗贲门失驰缓症

目的：探讨Boston大直径专用贲门扩张球囊治疗贲门失驰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：食管通条及球囊旋转成功率100％,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100％。152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驰缓症是简单而有效的方法,可以替代外科手术治疗。

Large-diameter balloon dilation in the treatment of esophageal achalasia]

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.