Naess F, Nygaard K
Gastroenterologisk avdeling, Ullevål sykehus, Oslo.
Tidsskr Nor Laegeforen. 1993 Nov 20;113(28):3466-9.
Achalasia was diagnosed in 57 patients from 1982 through 1991. 13 patients were evaluated by manometry both before and after pneumatic dilatation of the sphincter. There were no serious complications. All but one patient experienced good symptomatic effect; one patient was operated after two ineffective dilatations. The tonus and length of the lower oesophageal sphincter decreased significantly, but dilatation did not improve the swallow-induced relaxation of the sphincter, nor peristalsis in the oesophageal body. In three randomly selected patients, transcutaneous nervous stimulation did not have any symptomatic effects, nor did it affect the motility pattern of the oesophagus. Pneumatic dilatation of the lower oesophageal sphincter is a safe and effective first-choice treatment for achalasia, with myotomy being reserved for patients whose symptoms are not relieved successfully after two dilatations.
1982年至1991年期间，57例患者被诊断为贲门失弛缓症。13例患者在括约肌气囊扩张前后均接受了测压评估。未出现严重并发症。除1例患者外，所有患者均有良好的症状改善效果；1例患者在两次无效扩张后接受了手术治疗。食管下括约肌的张力和长度显著降低，但扩张并未改善吞咽引起的括约肌松弛，也未改善食管体部的蠕动。在随机选择的3例患者中，经皮神经刺激没有任何症状改善效果，也未影响食管的运动模式。食管下括约肌气囊扩张是贲门失弛缓症安全有效的首选治疗方法，对于两次扩张后症状仍未成功缓解的患者，则保留肌切开术。
