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目的探讨贲门失弛缓症患者的食管动力特征及肉毒毒素局部注射治疗后食管动力学的改变。方法28例患者内镜下局部注射肉毒毒素,分别于治疗前、治疗后1周、3个月时测定下食管括约肌的压力(LESP)、松弛率(LESRR)和食管体部的动力。结果治疗前,LESP为(42.68±17.16)mmHg,LESRR(38.69±3.66)%,吞咽时100%患者食管体部为同步收缩,无推进性蠕动波。肉毒毒素注射治疗后1周和3个月时,LESP分别为(23.35±4.86)mmHg和(22.74±4.02)mmHg,LESRR分别为(79.98±4.16)%和(80.48±3.79)%,但吞咽时食管体部的动力无改善。结论内镜下LES内注射肉毒毒素,可减低LESP和提高LESRR。
Objective To investigate the esophageal motility characteristics of patients with achalasia and the changes of esophageal motility after botulinum toxin injection. Methods Twenty-eight patients underwent endoscopic injection of botulinum toxin. The esophageal sphincter pressure (LESP), relaxation rate (LESRR) and esophageal motility were measured before treatment, 1 week and 3 months after treatment respectively. Results Before treatment, LESP was (42.68 ± 17.16) mmHg and LESRR (38.69 ± 3.66)%, respectively. The esophageal body of 100% swallowed patients had systolic contraction without propulsive peristalsis. LESP were (23.35 ± 4.86) mmHg and (22.74 ± 4.02) mmHg respectively at 1 week and 3 months after botulinum toxin injection, with LESRR of (79.98 ± 4.16)% and (80.48 ± 3.79)% respectively, but swallowing When esophageal motility no improvement. Conclusion Endoscopic injection of botulinum toxin in LES can reduce LESP and increase LESRR.