论文部分内容阅读
目的 探讨贲门失弛缓有效的介入治疗方法 ,并分析 3种介入治疗方法中远期疗效。方法 5 0例食管贲门失弛缓患者。其中球囊导管扩张术组 (A组 ) 30例 ;永久性金属内支架扩张组 (B组 )5例 ;暂时性金属内支架扩张术组 (C组 ) 15例。C组术后 3～ 7天由胃镜取出支架。结果 A组 30例共进行 5 6次球囊扩张 ,平均 1.9次。其中 13例增加直径分级扩张 3次 ;17例扩张 1次。B组 5例 ,安放不带膜支架 5只。C组 15例 ,安放部分带膜支架 15只 ,术后均用胃镜取出。A组贲门管腔直径术前为 (2 .4± 1.2 )mm ,术后为 (9.7± 3.0 )mm ;吞咽困难评分术前为 (2 .4± 1.2 )级 ,术后为 (1.0± 0 .3)级 ;主要并发症为疼痛和反流。超过 6个月的随访患者中 6 0 % (18/30 )复发吞咽困难 ,超过 1年的随访患者中90 % (18/2 0 )复发吞咽困难。B组贲门管腔直径术前为 (3.2± 2 .0 )mm ,术后为 (18.4± 1.7)mm ;吞咽困难评分术前为 (2 .4± 1.1)级 ,术后为 (0 .4± 0 .2 )级 ;主要并发症为疼痛、反流、出血和肉芽增生。超过 6个月的随访患者中 6 0 % (3/5 )复发吞咽困难 ,超过 1年的随访患者中 5 0 % (1/2 )复发吞咽困难。C组贲门管腔直径术前为 (3.4± 2 .9)mm ,术后为 (14.7± 2 .9)mm ;吞咽困难评分术前为 (2 .5± 1.1)级 ,术后为(0
Objective To investigate the effective methods of interventional treatment of achalasia and analyze the long-term effects of three interventional methods. Methods 50 cases of esophageal and cardiac achalasia patients. Among them, 30 cases were treated with balloon catheterization (group A), 5 cases with permanent metal stent dilatation (group B) and 15 cases with temporary metal stent dilatation (group C). C group 3 to 7 days after stent removed by gastroscope. Results A group of 30 patients conducted a total of 56 balloon dilation, an average of 1.9 times. Among them, 13 cases increased diameter grading and dilatation 3 times and 17 cases dilated once. B group 5 cases, placed without stent 5. C group of 15 cases, placed some of the stent with 15 cases were removed by gastroscope after surgery. In group A, the diameter of cardiac lumen was (2. 4 ± 1.2) mm preoperatively and (9.7 ± 3.0) mm postoperatively; the dysphagia score was (2. 4 ± 1.2) preoperatively and (1.0 ± 0) postoperatively .3); the main complication is pain and reflux. Sixty percent (18/30) of those who were followed up for more than 6 months had dysphagia and 90% (18/2) of those who were over 1 year had difficulty swallowing. The diameter of cardiac lumen in group B was (3.2 ± 2.0) mm preoperatively and (18.4 ± 1.7) mm postoperatively, and the dysphagia score was (2. 4 ± 1.1) preoperatively and (0.4 ± 0.2). The main complications were pain, reflux, hemorrhage and granulomatous hyperplasia. Sixty percent (3/5) of the patients who were followed up for more than 6 months had dysphagia and 50% (1/2) of those who were over 1 year had difficulty swallowing. The diameter of cardiac lumen in group C was (3.4 ± 2.9) mm preoperatively and (14.7 ± 2.9) mm postoperatively, and the score of dysphagia preoperatively was (2.5 ± 1.1) postoperatively