【摘要】 目的 :对 17例贲门失弛缓症患者扩张前后进行食管测压 ,研究贲门失弛缓症患者扩张治疗前后食管动力学特征及其与扩张疗效的关系。方法 :贲门失弛缓症患者 17例 ,所有患者根据临床表现、钡餐、内镜和食管测压确诊 ,并在确诊后行气囊扩张。 17例扩张治疗前、治疗后 3天以内及 3月 ,10例治疗后 1年观察临床症状积分及测压指标。结果 :( 1)扩张后患者的临床症状明显改善 ,且持续 1年 (P <0 .0 1)。 ( 2 )扩张后 3天至 1年 ,LESP、LESR均有改善 (P <0 .0 0 1、P <0 .0 5 ) ,以LESP下降尤为明显。 ( 3)扩张治疗前、治疗后 3天及 3月LESP <2 .5kPa分别为 6 1次和 11次 (P<0 .0 0 1) ,扩张前后LESR >80 %分别占 8.9%和 2 3.0 % (P <0 .0 0 1)。 ( 4 )扩张前全部病例食管体部均为非推进性同步收缩波 ,治疗后 3天、3月及 1年随访观察 ,仅 1例患者食管体部部分恢复推进性蠕动收缩。结论 :气囊扩张治疗贲门失弛缓症疗效好 ,不仅降低LESP而且改善LESR、缓解临床症状。选择气囊扩张治疗后是否再次扩张的主要观察指标除临床症状外 ,食管测压是最主要的随访方法 ,其中动力指标除LESP外 ,还需考虑LESR。更多还原

【Abstract】 Purpose: To investigate the esophageal motility before and after balloon dilation, and to explore the corelationship with dilation. Method: Clinical manifastation in 17 cases of achalasia, esophageal motor function and dilation treatment were assumed in all cases. A pneumhydroulic capillary perfusion system with 4 lumen catheter was used to record esophageal manometry through polygraph after over night fasting. The method was through out in all cases before dilation and 3 days? 3 months and 1 year after dilation. Result: (1)After treatment,LESP was very significantly lowered(P<0.01) and LESR was recovered (P<0.05). (2)The cases of LESP≥2.5 kPa before dilation and after 3 months were 61 and 11(P<0.001), LESR≥80% were 8.9% and 23%(P<0.001). (3)The motor patterns of esophageal body were nopropgated before and after dilation. Conclusion: The balloon dilation to treatment of achalasia was very useful and effective. The esophageal manometry is useful method for following up and offered helpful information for further dilation.更多还原