【摘要】 目的评价内镜直视下机械扩张治疗贲门失弛缓症的疗效。方法利用自行设计并改良的机械扩张器械在上消化道内镜直视下对62例贲门失弛缓症进行机械扩张。其中1例为Heller手术失败,4例为气囊扩张失败。结果2例食管破裂中转开胸手术治愈;1例不能耐受手术而放弃;1例一次扩张效果不好,二次扩张后痊愈;其余58例一次成功。扩张时间2～5min,平均3.5min。术中均见黏膜少量出血,无活动性出血。术后2小时进冷流质饮食,6小时后软成形饮食,之后过渡为普通饮食。58例随访2～11年,平均7.5年,均获治愈。结论内镜直视下机械扩张贲门失弛缓症创伤小,费用低,无反流,长期随访效果可靠,有推广价值。更多还原

【Abstract】 Objective To evaluate the effect of mechanical dilation on cardia achalasia under an endoscope.Methods A total of 62 patients with cardia achalasia were treated with mechanical dilation by using a self-designed dilator under a gastroscope.Of the cases,one had experienced a failure of heller surgery,and four had received ballon dilation before the gastroscopy.Results Among the cases,2 were convered to open thoracic surgery becaues of rupture of the esophagus,1 patient could not tolerate the operation,1 received a second dilation because of unsatisfied outcome of the first attempt.In the other 58 patients,the surgery was completed in the first attempt.The mean dilation time was 3.5 minutes(ranged from 2 to 5 minutes).Slight mucosal hemorrhage was observed during the operation,while no continuous bleeding occurred.Cold liquid diet was given to the patients 2 hours after the dilation,and then semiliquid diet was prescribed in 6 hours,after that the patients began to take normal diet gradually.The patients were followed up for 2 to 11 years with a mean of 7.5.All of them were cured without recurrence.Conclusions Endoscopic mechanical dilation is microinvasive,safe,and effective for cardia achalasia.It is worth being widely used because of a low cost and reliable long-term outcomes.更多还原