应用肉毒毒素治疗贲门失弛缓症的临床观察

Clinical studies on botulin toxin curing achalasia of cardia

关键词:  肉毒毒素  贲门失弛缓症  环形点注

Key words:  botulin toxin  achalasia  local annular injection

摘要:

［目的］ 验证肉毒毒素治疗贲门失弛缓症(AC)的疗效，提出延长药效的优化方案。［方法］ 对16例贲门失弛缓症的病人进行窥镜下肉毒毒素环形点注后临床观察。［结果］ 通过窥镜注药治疗前后症状积分降低与贲门扩张程度均有显著差异（P<0.001），其有效率达93.7%。反转注射法与常规法，定期复注与单注法二项比较，其延长疗效作用均有显著差异(P<005)，维持疗效的时间超过1.5年。［结论］ 肉毒毒素治疗AC是有效的疗法，提出针头刺入深度、定期复注和反转注射法等优化方案，治疗AC更为有效而实用的途径。

Abstract:

［Objetive］Botulin toxin had been widely applied to cure achalasia of the cardia at home and abroad. But how to prolong and to enhance its effects was controversial. ［Methods］In our research, sixteen patients diagnosed as achalasia of the cardia were investigated after localannular injection.［Results］ It had been discovered that dysphagia was ameliorated for cardiac sphincter dilating quickly induced by this cure. There was a significant difference between the symptoms that of curing ahead and curing behind (P<0.001).And the efficiency of this remedy is 93.6%. It was showed that this treatment was safety and effective method. Twelve patients diagnosed as achalasia of the cardia were followed up to extend improve its curative effects.［Conclusion］ It is clearly demonstrated that the optimized therapy composed of regulating the vertical injection depth, reverse injection and periodical injecting to recrudescent patients is a more effective and practical method by clinical studies