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。%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.
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