气囊扩张术联合肉毒素注射序惯治疗贲门失弛缓症的近期及远期疗效
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弭希峰, 黄子成, 王木成, 李水淼
气囊扩张术;A型肉毒素;失弛缓症,弭希峰，黄子成，王木成，李水淼，,通讯作者：,Short-termandlong-termeffecto
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弭希峰，黄子成，王木成，李水淼，福建医科大学临床教学医院泉州市第一医院内窥镜科 福建省泉州市 362000
通讯作者：弭希峰，362000，福建省泉州市鲤城区东街250号，福建省泉州市第一医院内窥镜科.
电话：0595-22277329
收稿日期：2005-06-28 接受日期：2005-07-28
Short-term and long-term effect of pneumatic dilation and botulinum toxin injection in treatment of cardiac achalasia
Xi-Feng Mi, Zi-Cheng Huang, Mu-Cheng Wang, Shui-Miao Li
Xi-Feng Mi, Zi-Cheng Huang, Mu-Cheng Wang, Shui-Miao Li, Department of Endoscopy, the First Hospital of Quanzhou City, Clinical Teaching Hospital of Fujian Medical University, Quanzhou 362000, Fujian Province, China
Correspondence to: Xi-Feng Mi, Department of Endoscopy, the First Hospital of Quanzhou, 250 Dong Road, Licheng District, Quanzhou 362000, Fujian Province, China
Received: 2005-06-28 Accepted: 2005-07-28
Abstract
AIM: To evaluate the short-term and long-term effect of the pneumatic dilation and botulinum toxin A (BTXA) injection for the cardiac achalasia.
METHODS: From July 2000 to May 2004, 35 patients with cardiac achalasia received pneumatic dilation and BTXA injection in our hospital. The improvement of the dysphagia was observed 1 and 12 mo after the treatment.
RESULTS: Of the 35 patients, their conditions of dysphagia were significantly improved. The efficacy rates were 100% and 93.9% in the following up (1 and 12 mo, respectively). Two patients were lost to follow up while dysphagia relapsed in three patients during the following up.
CONCLUSION: The pneumatic dilation and BTXA injection for cardiac achalasia is safe, stable and effective in the treatment of cardiac achalasia.
Key Words: Pneumatic dilation; Botulinum toxin A; Achalasia
Mi XF, Huang ZC, Wang MC, Li SM. Short-term and long-term effect of pneumatic dilation and botulinum toxin injection in treatment of cardiac achalasia. Shijie Huaren Xiaohua Zazhi 2005;13(17):2159-2161
摘要
目的：探讨气囊扩张术联合A型肉毒素(botulinum toxin A，BTXA)注射序惯治疗贲门失弛缓症的近期及远期疗效.
方法：收集2000-07/2004-05在我院确诊的行内镜下气囊扩张术联合肉毒素注射治疗的贲门失弛缓症患者35例，观察术后1及12 mo以上吞咽困难症状改善情况.
结果：共35例患者，所有患者术后吞咽困难消失或明显改善，随访1及12 mo有效率分别为100%和93.9%.1 a失访共2例，复发共3例.
结论：气囊扩张术联合内镜下肉毒素注射治疗贲门失弛缓症疗效好，长期疗效稳定，操作安全，有进一步研究应用的前景.
关键词：气囊扩张术；A型肉毒素；失弛缓症
弭希峰，黄子成，王木成，李水淼. 气囊扩张术联合肉毒素注射序惯治疗贲门失弛缓症的近期及远期疗效. 世界华人消化杂志 2005;13(17):2159-2161
0 引言
贲门失弛缓症为食管运动功能障碍性疾病，吞咽困难症状顽固且不断加重，药物治疗效果差.单纯扩张治疗或肉毒素注射治疗远期疗效低，我们近年来开展了内镜下气囊扩张术联合肉毒素注射治疗此病，取得了满意效果及一些经验，现总结如下.
1 材料和方法
1.1材料 自2000-07/2004-05我院收治的贲门失弛缓症病人35例，其中男16例，女19例，年龄17-68岁，平均38.5岁，病程3 mo-24 a，平均5.5 a.既往治疗：口服药物治疗28例(80.0%)，单纯其他扩张治疗3例(8.6%)，未经任何治疗4例(11.4%).
1.2 方法
1.2.1 临床症状 所有患者均有不同程度的吞咽困难(100%)，其吞咽困难按stooler分级法[1]分4级：Ⅰ级：能进软食；Ⅱ级：能进半流饮食；Ⅲ级：能进流质饮食；Ⅳ级：不能进食.其中Ⅰ级6例(17.1%)，Ⅱ级11例(31.4%)，Ⅲ级11例(31.4%)，Ⅳ级7例(20%)，呕吐与反流30例(85.7%)，胸骨后疼痛29例(82.9%).
1.2 ......
弭希峰，黄子成，王木成，李水淼，福建医科大学临床教学医院泉州市第一医院内窥镜科 福建省泉州市 362000
通讯作者：弭希峰，362000，福建省泉州市鲤城区东街250号，福建省泉州市第一医院内窥镜科.
电话：0595-22277329
收稿日期：2005-06-28 接受日期：2005-07-28
Short-term and long-term effect of pneumatic dilation and botulinum toxin injection in treatment of cardiac achalasia
Xi-Feng Mi, Zi-Cheng Huang, Mu-Cheng Wang, Shui-Miao Li
Xi-Feng Mi, Zi-Cheng Huang, Mu-Cheng Wang, Shui-Miao Li, Department of Endoscopy, the First Hospital of Quanzhou City, Clinical Teaching Hospital of Fujian Medical University, Quanzhou 362000, Fujian Province, China
Correspondence to: Xi-Feng Mi, Department of Endoscopy, the First Hospital of Quanzhou, 250 Dong Road, Licheng District, Quanzhou 362000, Fujian Province, China
Received: 2005-06-28 Accepted: 2005-07-28
Abstract
AIM: To evaluate the short-term and long-term effect of the pneumatic dilation and botulinum toxin A (BTXA) injection for the cardiac achalasia.
METHODS: From July 2000 to May 2004, 35 patients with cardiac achalasia received pneumatic dilation and BTXA injection in our hospital. The improvement of the dysphagia was observed 1 and 12 mo after the treatment.
RESULTS: Of the 35 patients, their conditions of dysphagia were significantly improved. The efficacy rates were 100% and 93.9% in the following up (1 and 12 mo, respectively). Two patients were lost to follow up while dysphagia relapsed in three patients during the following up.
CONCLUSION: The pneumatic dilation and BTXA injection for cardiac achalasia is safe, stable and effective in the treatment of cardiac achalasia.
Key Words: Pneumatic dilation; Botulinum toxin A; Achalasia
Mi XF, Huang ZC, Wang MC, Li SM. Short-term and long-term effect of pneumatic dilation and botulinum toxin injection in treatment of cardiac achalasia. Shijie Huaren Xiaohua Zazhi 2005;13(17):2159-2161
摘要
目的：探讨气囊扩张术联合A型肉毒素(botulinum toxin A，BTXA)注射序惯治疗贲门失弛缓症的近期及远期疗效.
方法：收集2000-07/2004-05在我院确诊的行内镜下气囊扩张术联合肉毒素注射治疗的贲门失弛缓症患者35例，观察术后1及12 mo以上吞咽困难症状改善情况.
结果：共35例患者，所有患者术后吞咽困难消失或明显改善，随访1及12 mo有效率分别为100%和93.9%.1 a失访共2例，复发共3例.
结论：气囊扩张术联合内镜下肉毒素注射治疗贲门失弛缓症疗效好，长期疗效稳定，操作安全，有进一步研究应用的前景.
关键词：气囊扩张术；A型肉毒素；失弛缓症
弭希峰，黄子成，王木成，李水淼. 气囊扩张术联合肉毒素注射序惯治疗贲门失弛缓症的近期及远期疗效. 世界华人消化杂志 2005;13(17):2159-2161
0 引言
贲门失弛缓症为食管运动功能障碍性疾病，吞咽困难症状顽固且不断加重，药物治疗效果差.单纯扩张治疗或肉毒素注射治疗远期疗效低，我们近年来开展了内镜下气囊扩张术联合肉毒素注射治疗此病，取得了满意效果及一些经验，现总结如下.
1 材料和方法
1.1材料 自2000-07/2004-05我院收治的贲门失弛缓症病人35例，其中男16例，女19例，年龄17-68岁，平均38.5岁，病程3 mo-24 a，平均5.5 a.既往治疗：口服药物治疗28例(80.0%)，单纯其他扩张治疗3例(8.6%)，未经任何治疗4例(11.4%).
1.2 方法
1.2.1 临床症状 所有患者均有不同程度的吞咽困难(100%)，其吞咽困难按stooler分级法[1]分4级：Ⅰ级：能进软食；Ⅱ级：能进半流饮食；Ⅲ级：能进流质饮食；Ⅳ级：不能进食.其中Ⅰ级6例(17.1%)，Ⅱ级11例(31.4%)，Ⅲ级11例(31.4%)，Ⅳ级7例(20%)，呕吐与反流30例(85.7%)，胸骨后疼痛29例(82.9%).
1.2 ......
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