摘要
目的 探讨A型肉毒毒素局部注射治疗贲门失弛缓症前后的食管动力变化及疗效。方法 在内镜下用Wilson Cook、2 5G注射针选择贲门齿状线上 1cm部位 3、6、9、12点于食管黏膜面 45°角进针 5mm注射A型肉毒毒素 (兰州生物制品研究所生产 ,(97)卫药准字 (兰 )S 0 1号 ) ,每点 2 0～ 2 5U ,共 80～ 10 0U ,术后禁食 4～ 6小时。用瑞典CTDPCPolyraf多导胃肠功能测定仪对7例患者分别于注射治疗前后作了下食管括约肌静息压 (LESP)压力及松弛率 (LESR)、吞水时食管体部蠕动以及食管内 2 4小时pH检测。结果 7例患者治疗前静息压 (LESP)为 (7 5 8± 1 6 5 )kPa ,松弛率 (LESR)为 (2 9 6 9± 3 44) % ,吞水时食管体部均为细小杂乱低平非推进性收缩波 ,治疗后 1周LES静息压 (LESP)降至 (3 5 1± 0 38)kPa ,松弛率 (LESR)为 (5 1 94± 3 5 8) %明显升高 (P <0 0 1) ;吞水时食管体部均为细小杂乱低平非推进性收缩波 ,治疗后 1周出现低平规律性同步蠕动波 ;注射治疗前后食管 2 4小时pH检测显示无异常反流 ,临床症状明显改善 ,可进半流质及普食。 7例均未发生任何并发症。结论 贲门失弛缓症患者存在明显的食管动力障碍 ,A型肉毒毒素局部注射治疗是行之有效的方法 ,无副作用 ,也无并发症 ,门诊即可进行 。
Aim To research on the changes and therapeutic effects of esophagus kinematics before and after the treatment of achalasia of cardia with injection of type A kreotoxin.Methods To inject 80～100 U type A kreotoxin(Lanzhou bio product researchinstitute,(97)medicine authorized No.(Lan)S-01),20～25 U every point with Wilson Cook and 25G injector,injection position:1 cm above the cardia dentoid line,3,6,9 and 12 point in 45 angle on the esophageal mucosa,injection depth:5 mm under esophagoscopy,fasting for 4～6 hours after operation.To observe esophagus sphincter muscle quiescent pressure(LESP) and laxation rate (LESR),esophagus verrmicular movement while swallowing water,the Phvalues for 24 hours in esophaguses of 7 cases with Sweden CTD PC Polyraf multi duct gastrointestinal function apparatus.Results Before treatment in 7 cases the LESP is(7.58±1 65)kpa,LESR is (29 69±3 44)%,and small,disorder,low and non advancing constricted waves appeared while victims swallowed water,after treatment for one week,the LESP is (3 51±0 38)kPa,LESR is (51 94±3 58)% markedly improved ( P <0 01),and small,disorder,low and non advancing constricted waves appeared while they swallowed water,after treatment for one week,the low,regular and synchronous vermicular waves appeared.No abnormal regurgitation appeared by esophagus pH observation within 24 hours before and after the treatment with injection,clinical symptoms were markedly alleviated,the victims can eat semi liquid and liquid diet.No complications appeared in 7 cases.Conclusions Victims with cardiochalasia have marked esophageal myogenic dyskinesia,the treatment with injection of type A kreotoxin is an effective way without side effects and complications.It can be operated in out patient departments,moreover,it is low cost.
出处
《胃肠病学和肝病学杂志》
CAS
2001年第2期158-160,共3页
Chinese Journal of Gastroenterology and Hepatology
