内镜直视下气囊扩张法治疗贲门失弛缓症

目的观察经内镜气囊扩张治疗贲门失弛缓症的疗效。方法应用贲门失弛缓扩张器（Microvasive Rigiflex Balloon Dilatation，MRBD）在内镜直视下对44例贲门失弛缓症进行扩张治疗。结果每例每次插管扩张3～5次，44例共扩张158.4（平均3.6）次。扩张压力为15～19（平均16、7）Psi。全部患者经一次插管3～5次的反复扩张后，贲门立即较术前明显增大，内镜可无任何阻力顺利通过；20h后吞咽困难完全消失，患者顺利进普通饮食；48h食管钡剂摄片，示食管宽度由扩张前的平均3，47cm缩小至扩张后的平均1．5cm，责门由扩张前的线形增加到扩张后的平均1.4cm，一次扩张的近期疗效为100％。未发生穿孔及出血等严重并发症。结论MRBD为当前治疗本病安全、简便的方法，较传统扩张法为优，应列为首选。

Micro-vasive Rigiflex Balloon Dilatation Under Endoscope for the Treatment of Achalsia

Objective To observe the theraputic effect of micro-vasive regiflex balloon dilatation(MRBD) under endoscope for the treatment of achalsia. Methods Forty-four patients with achalsia were treated with MRBD under endoscope. Results Each patient was dilated for 3-5 times(the average dilation was 3.6 times per patient;the total sum was 158.4 times) . The dilated pression was 15-19 Psi(the average pression was 16.7Psi) . All cases were significantly relieved after the treatment. The symptom of swallow difficulty disappeared 20 hours after the treatment. The images of X-ray were improved significantly. The width of oesophagus reduced from 3.47cm to 1.5cm and cardiac width increased to 1.4cm. The curative effect in the short term was 100%. The com-plications of perforation,rupture and haemorrhage were not found in our research. Conclusion Compared with the traditional method,MRBD under endoscope has the advantages of convenience,safety and effectiveness. Thus,it should be the first choice for the treatment of achalsia.