CAJ | 학술논문

目的：探讨可取金属支架治疗贲门失弛缓症的临床疗效及安全性。方法选取30例来我院就诊的贲门失弛缓症患者，随机分为支架组和气囊组，支架组行可回收金属支架置入，气囊组行内镜下气囊扩张术，对比两组患者治疗前、治疗1个月后、半年后的吞咽困难分级、临床症状评分和食管检查情况，同时对比治疗中常见并发症发生情况。结果(1)两组患者治疗1个月后、半年后吞咽困难分级、临床症状评分均低于治疗前(P<0.05)。(2)治疗1个月后两组吞咽困难分级、临床症状评分比较，无统计学差异(P>0.05)，治疗半年后支架组的吞咽困难分级及临床症状评分均低于气囊组(P<0.05)；(3)两组患者治疗后的食管最大直径均显著低于治疗前(P<0.05)，贲门最狭窄处直径均显著高于治疗前(P<0.05)；(4)治疗中支架组的出血、穿孔、疼痛等常见并发症发生率低于气囊组(P<0.05)，反流高于气囊组(P<0.05)。结论内镜下可取金属支架治疗贲门失弛缓症操作简便、安全有效，与气囊扩张术比较，远期疗效更优，并发症轻且少。
목적：탐토가취금속지가치료분문실이완증적림상료효급안전성。방법선취30례래아원취진적분문실이완증환자，수궤분위지가조화기낭조，지가조행가회수금속지가치입，기낭조행내경하기낭확장술，대비량조환자치료전、치료1개월후、반년후적탄인곤난분급、림상증상평분화식관검사정황，동시대비치료중상견병발증발생정황。결과(1)량조환자치료1개월후、반년후탄인곤난분급、림상증상평분균저우치료전(P<0.05)。(2)치료1개월후량조탄인곤난분급、림상증상평분비교，무통계학차이(P>0.05)，치료반년후지가조적탄인곤난분급급림상증상평분균저우기낭조(P<0.05)；(3)량조환자치료후적식관최대직경균현저저우치료전(P<0.05)，분문최협착처직경균현저고우치료전(P<0.05)；(4)치료중지가조적출혈、천공、동통등상견병발증발생솔저우기낭조(P<0.05)，반류고우기낭조(P<0.05)。결론내경하가취금속지가치료분문실이완증조작간편、안전유효，여기낭확장술비교，원기료효경우，병발증경차소。
Objective To observe the clinical efficacy and investigate its safety of esophageal achalasia with retrievable metal stents. Methods Thirty cases for esophageal achalasia in our hospital were selected, and they were randomly divided into stent group and balloon group. The former were treated by retrievable metal stent, and the latter were treated endoscopic balloon-dilating. The dysphagia grade, clinical symptom scores and the situation of esophageal in-spection before treatment,after 1 month and 6 months of treatment, and the common complications were compared be-tween two groups. Results (1)The rusults of two groups in dysphagia grade and clinical symptom scores after 1 month and 6 months' treatment were obviously lower than those before therapy(P<0.05).(2)Two groups patients in dysphagia grade and clinical symptom scores after 1 month's treatment had no statistical difference (P>0.05),and after six months' treatment, the stent group patients' dysphagia grade and clinical symptom scores were lower than balloon group (P<0.05). (3)After treatment, the maximum diameter of the esophagus of two groups patients were significantly lower than before treatment (P<0.05), and the narrowest diameter of the cardia were significantly higher than before treatment (P<0.05).(4)The rates of common complications such as hemorrhage, perforation, pain, stent group were lower than the balloon group(P<0.05),but reflux stent group was higher than the balloon group(P<0.05). Conclusion The treatment of esophageal achalasia with endoscopic retrievable metal stent is simple, safe and effective, compared with balloon-dilating,its long-term efficacy is more excellent,and the complications are more lighter and less.