内镜直视下球囊扩张治疗贲门失弛缓症

目的：探讨内镜直视下球囊扩张治疗贲门失弛缓症的疗效。方法：内镜直视下应用食管球囊扩张器对失弛缓贲门进行扩张，术后定期随访，经内镜和上消化道钡餐检查，对症状缓解或复发与否进行评价。结果：38例中重度贲门失弛缓症状消失，经1-3次扩张治疗，吞咽困难症状消失，缓解率依次为42．11％(16/38)、90．91％(20/22)、100.00％(2／2)。有贲门粘膜撕裂、渗血者76．32％(29／38)，但无大出血及穿孔等并发症。每0．5、1、2、3年各随访一次，平均1．8年，复发率依次5．26％(2／38)、10．53％(4／38)、15．79％(6/38)、16．67％(5/30)(P＞0．05)。0．5年内出现反酸，烧心者为3l.58％(12／38)，经内镜诊断为轻度反流性食管炎21．05％(8／38)，以后随访中未发现。结论；内镜立视下球囊扩张治疗贲门失弛缓症近期疗效肯定，远期疗效满意，是一种比较安全的治疗方法。

ENDOSCOPIC DIRECT OPTICAL BALLOON DILATATION THERAPY FOR ACHALASIA

Objective:To evaluate the efficacy of endoscopic direct optical balloon therapy for achalasia. Methods:Patients with achalasia were treated by esophageal balloon dilatation under endoscopy , followed up survey by endoscopy and esophageal barium radiography as well as their symptoms were investigated periodically . Results:The dysphagia symptoms remitted in all of the 38 patients were treated by one, two or three times. The rate of remission was 42.11% (16/38) , 90.91% (20/22) , 100.00% (2/2) cardiac orifice mucosal laceration and oozing of blood was 76.32% (29/38), but without complication of perforation and massive hemorrhage. The following up ranged from 6 months to over 3 years, four times, and average was 1.8 years . The rate of recurrence of symptoms was 5.26% (2/38), 10.53% (4/38),15.79%(6/38), 16.67%(5/30)respectively. In addition, there were 31.58%(12/38) of patients with acid-reflux symptoms in 0.5 years, and 21.05%(8/38) reflux esophagitis during the followed-up.Conclusion: Endoscopic esophageal balloon dilatation for achalasia is an effective and safe method not only in the short-term but also in the long-term.