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目的观察与评价胃镜下通过气囊与探条扩张器对食道贲门失弛缓症治疗的安全性和疗效。方法 7例经X线及胃镜确诊的食道贲门失弛缓症患者,5例接受气囊扩张治疗,2例运用探条扩张器,同时观察胃镜下扩张疗法的安全性及远、近期疗效。结果 (1)7例病人均一次性治疗成功,术后2小时均能进食,吞咽困难、呕吐等缓解率达到100%。(2)术中病人诉轻微胸骨后疼痛,食道贲门处粘膜轻度撕裂,经镜下喷洒8%冰盐水去甲肾液即可止血,未出现穿孔、大出血等并发症。(3)远期疗效,5例气囊扩张患者观察四年,未见复发,1例探条扩张器在第一年复发,再经气囊扩张后未再复发。结论胃镜下扩张术治疗食道贲门失弛缓症,操作简单,并发症少,近期疗效明显,远期效果确切,是临床上治疗食道贲门失弛缓症的首选方法。
Objective To observe and evaluate the safety and curative effect of gastroscope and probe dilator on esophageal achalasia. Methods Seven patients with esophageal and cardiac achalasia diagnosed by X-ray and gastroscopy were enrolled. Five patients underwent balloon dilatation and two using dilator dilator. The safety and long-term and short-term efficacy of endoscopic dilation were also observed. Results (1) All the 7 patients were treated successfully in one time, and were able to eat for 2 hours after operation. The rate of dysphagia and vomiting was 100%. (2) intraoperative patients complained of slight post-sternal pain, mild esophageal mucosa tear, by the mirror spray of 8% ice saline to stop the bleeding, no perforation, bleeding and other complications. (3) Long-term curative effect. Five cases of balloon dilatation were observed for four years. No recurrence was observed. One case of dilator dilated in the first year and no recurrence after balloon dilatation. Conclusions Gastroscopic dilation is an effective and safe method for the treatment of achalasia of esophagus and cardia. It has the advantages of simple operation, fewer complications, obvious curative effect in the short term and definite long-term effect. It is the first choice for the treatment of achalasia in esophagus and cardia in clinic.