- 期刊
Endoscope Guided Balloon Dilatation in Esophageal Achalasia
食道賁門失弛緩症之內視鏡氣球擴張治療
摘要
為求評估內視鏡指引下氣球擴張治療術對於食道賁門失弛緩症病人之治療效果，本院五年來有21例病人接受此項治療，列入對象包括男11例，女10例，其平均年齡為36歲。食道賁門失弛緩症程度之分類屬第二度者18例，第一度者3例（皆為藥物治療失敗者），第三度者則不予列入此種治療計劃。所使用之氣球為Microvasive公司之 Rigiflex Achalasia 3公分充氣擴張氣球。內視鏡每星期追蹤一次，必要時再予擴張。 總共21例病人接受42次之擴張治療，每例接受1至5次不等，平均為2次。結果4例反應良好，飲食正常：8例有改善，僅在食用肉類、麵包或乾飯時有所不適；6例稍有改善，僅在食用半固體或稀飯時有所不適。只有3例無反應，吞嚥仍困難。經半年至4年，平均2年之追蹤，有2例病人在接受3次及5次擴張後效果不佳而接受手術，另有1例只接受1次擴張後即失去追蹤，原因不明。治療期間未發現有嚴重之併發症。 由以上經驗顯示內視鏡氣球擴張術是一安全、有效而技術單純之治療方式，尤其對第二度食道賁門失弛緩症病例是最佳之療法，對第一度而藥物治療效果不佳者，或第三度而不適合或不願意接受手術者，也不失為另一種值得一試之治療選擇。
並列摘要
Twenty-One patients received endoscope guided balloon dilatation for esophageal achalasia between 1987 and 1991, including 11 male and 10 female patients. The average age was 36 years old. The grade of achalasia included grade I, 3 cases; grade Ⅱ, 18 cases; and grade Ⅲ, 0 cases. The duration between appearance of clinical symptoms and diagnosis was 2.1 years on average, with a range of 0.5 to 7 years. The balloon dilator used was the Microvasive Rigiflex Achalasia dilator with a 30 mm air-inflated balloon. The endoscopic follow up interval was one week. A total of 42 dilatations were done in these 21 patients with an average of 2/case (range: 1-5). The outcome of dilatation was ”good” in 4 cases, ”improved” in 8 cases, ”slightly improved” in 6 cases, with only 3 cases having ”no response”. The follow up period was 2 years on average (range: 0.5-4 years). Two cases were lost to follow up due to operation after dilatation failure (one with 5 dilatations, one with 3 dilatations), one case was lost after one dilatation for unknown reasons. In this series, we found the endoscope guided balloon dilatation to be a safe, effective and simple method for the management of esophageal achalasia in cases of grade Ⅱ or grade I when a drug therapy regimen was ineffective.