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目的：探讨贲门失弛缓症患者食管动力学、贲门部括约肌结构及气囊扩张的疗效。方法：用瑞典ＣＴＤＰＣＰｏｌｙｒａｆ液压毛细灌注系统对１５例患者分别于扩张治疗前后作了下食管括约肌（ＬＥＳ）压力及其松弛率、食管体腔内压力、干咽蠕动以及食管内２４ｈｐＨ检测，并用超声内镜（ＥＵＳ）探查贲门部括约肌结构，在内镜及Ｘ线监视下，用ＯＴＷ气囊扩张，压力为１３８ｋＰａ，维持时间１０～３０ｓ，反复２～３次。并联合Ｃａ２＋通道拮抗剂及胃肠动力药治疗。结果：１５例患者治疗前ＬＥＳ压力为（７．５９±１．４３）ｋＰａ，松弛率为３５．６％，食管体腔内压为（６．０８±２．３７）ｋＰａ，干咽时食管无蠕动，扩张治疗后ＬＥＳ压力为（３．１２±１．５７）ｋＰａ，食管体腔内压力为（５．１６±２．１９）ｋＰａ，均明显降低，松弛率明显升高（Ｐ＜０．０１）。ＥＵＳ检查未发现贲门部结构明显异常，扩张治疗前后食管２４ｈｐＨ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。１例患者扩张后食管下端穿孔而手术治疗，其余１４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，但ＥＵＳ显示贲门部结构未见明显异常，扩张疗效显著，不会造成胃食管反流。食管穿?
Objective: To investigate the effects of esophageal motility, cardia sphincter structure and balloon dilatation in patients with achalasia. Methods: The pressure of the lower esophageal sphincter (LES) and its relaxation rate, intra-esophageal cavity pressure, dry pharynx peristalsis and intra-esophageal 24hpH were measured in 15 patients before and after dilation treatment with the Swedish CTDP CPolyraf hydraulic capillary perfusion system. (EUS) to explore the cardia sphincter structure, endoscopic and X-ray monitoring, with OTW balloon dilatation, pressure 138kPa, the maintenance of time 10 ~ 30s, repeated 2 ~ 3 times. And combined with Ca2 + channel antagonist and gastrointestinal motility drug treatment. Results: Before treatment, LES pressure was (7.59 ± 1.43) kPa, relaxation rate was 35.6%, intra-esophageal pressure was (6.08 ± 2.37) kPa, The pressure of LES was (3.12 ± 1.57) kPa and the pressure in the esophageal cavity was (5.16 ± 2.19) kPa after peristaltic and dilatation treatment, respectively, both decreased obviously and the relaxation rate increased significantly (P <0.01) ). EUS examination found no obvious abnormality of cardia structure, 24h after esophageal expansion therapy before and after the test showed no abnormal reflux, clinical symptoms improved significantly, can be semi-liquid and the general diet. One patient underwent esophageal perforation after surgical expansion, and the remaining 14 patients had no complications. Conclusion: There are obvious esophageal motility disorders in patients with achalasia. However, there is no obvious abnormality of cardia structure in EUS, and the effect of dilatation is significant, which will not cause gastroesophageal reflux. Esophageal wear?