摘要目的 评价内镜下球囊扩张治疗贲门失弛缓症( AC)的中远期疗效.方法 应用内镜下球囊扩张术治疗45例患者,术后随访2～12年,治疗前后行Eckardt评分及Stooler分级,评价扩张治疗的疗效.结果 内镜下球囊扩张术手术成功率为 97. 8%( 44/45),症状有效缓解率 93. 2%(41/44),未发生大量出血、穿孔等严重并发症.术后随访最长至144个月,10例术后超过60个月.术后吞咽困难症状明显缓解(P＜0. 01).术后24个月及60个月的Eckardt评分均较术前有显著降低( P＜0. 01),但术后60个月的Eckardt评分较术后24个月有所回升(P＜0. 01).统计分析显示,病程与术后评分呈明显正相关(P＜0. 01),与治疗效果呈明显负相关(P＜0. 01).结论 内镜下球囊扩张术治疗AC,具有良好的治疗效果,且安全性较高.

abstractsObjective To evaluate the mid-to-long term therapeutic effect of endoscopic pneumatic dilation for achalasia of cardia (AC).Methods Endoscopic pneumatic dilation was used in 45 AC patients, with follow-up of 2-12 years. Eckardt score and Stooler grading were used before and after the operation for evaluation of curative effect of dilation. Results The operation success rate was 97. 8%( 44/45) and the effective remission rate was 93. 2%( 41/44 ). No massive hemorrhage, perforation or other serious complications occurred.The longest follow-up time was up to 144 months.Ten cases were followed up for over 60 months. Patients′symptoms relieved significantly (P＜0. 01). Eckardt scores in 24 months and 60 months after operation significantly decreased compared with those before the operation ( P＜0. 01). But Eckardt score in 60 months was higher than that in 24 months ( P＜0. 01). The length of the disease history was positively related to post-operative scores, and negatively related to efficacy ( P＜0. 01). Conclusion Endoscopic balloon dilation is a satisfactory therapy to AC with good efficacy and safety.