Pneumatic Dilatation in Achalasia under Fluoroscopic Guidance Fluoroscopic Guidance

X光透視導引下食道賁門失弛緩症之氣球擴張治療

徐以信(Yi-Hsin Hsu) ； 楊國卿(Kuo-Ching Yang) ； 孫灼基(Cho-Chi Sun) ； 陳瑞灝(Jui-Hao Chen) ； 劉玉華(Yuh-Hwa Liu) ； 王建民(Gen-Ming Wang) ； 陳良光(Liang-Kuang Chen) ； 符振中(Jene-John Fu)

《中華民國消化系醫學雜誌》 13卷3期 (1996/09) Pp. 226-233

https://doi.org/10.6557/GJTb.199609_13(3).0001

摘要

氣球擴張術為原發性食道賁門失弛緩症的第一線治療方式。迄今有各種不同的擴張器及導引方法被使用過。在X光透視的導引下，我們使用Microvasive公司之Rigiflex achalasia3公分氣球擴張器為11例（男6例，女5例，平均年齡51歲）食道賁門失弛緩症的病人進行治療，並評估其效果及其安全性。
前後共完成13次擴張術。有10例(91%)接受第一次擴張後得到緩解。其中1例(10%)於追蹤至第四個月時再度發生症狀。2例（再發病例及第一次治療無效病例）接受第二次擴張術治療（以相同大小擴張器），結果皆無改善。最後成功率為82%(9/11)，平均追蹤時間為15.6個月。1例(9%)發生輕度胃食道逆流。
結論：在X光透視導引下，以Rigiflex achalasia3公分氣球擴張器來治療食道賁門失弛緩症的病人是安全有效的方法。對於需要進行重覆擴張術治療病例，我們建議使用規格較大的擴張器，以期有較佳效果。

關鍵字

食道賁門失弛緩症 ； X光透視 ； 氣球擴張術

並列摘要

Pneumatic dilatation is a first-line treatment for primary achalasia. Various balloons and guiding methods have been used. We used the 30-mm Rigiflex achalasia dilator under fluoroscopic guidance for 11 consecutive cases (6 males, 5 females, mean age of 51) of achalasia. A total of thirteen dilatations were performed. Ten cases (91%) were treated successfully after the first dilatation; among these cases, one (10%) had symptomatic recurrence 4 months after the treatment. However, no response to initial dilatation occurred in one case (9%). A second dilatation with a balloon of the same size failed to improve the nonresponder and the recurrent patient. The final success rate was 82% (9/11). The mean follow-up period is 15.6 months (range 3-31 months). Mild gastroesophageal reflux occurred in one case (9%). We conclude that it is effective and safe to treat achalasia with pneumatic dilatation using a 30-mm Rigiflex dilator under fluoroscopic guidance. Moreover, if repeated dilatation is needed, we recommend that a balloon of larger diameter be chosen to improve the outcome.

並列關鍵字

achalasia ； fluoroscopy ； pneumatic dilatation