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目的 系统评价内镜下球囊扩张和支架植入治疗贲门失弛缓症的有效性和安全性.方法 检索外文数据库MedLine、Embase、ISI Web of Science、The Cochrane Library以及中文数据库中国生物医学文献数据库和万方数据库,检索时限从建库至2015年12月.由2位研究者独立筛选文献、提取资料和评价文献,然后应用RevMan 5.3统计软件进行meta分析.结果 共有4篇文献总共343例患者纳入本meta分析,其中球囊扩张组176例,支架植入组167例.meta分析结果显示,球囊扩张和支架植入治疗贲门失弛缓症患者的术后短期(术后1个月内)症状缓解率比较差异无统计学意义[RR=1.03,95％ CI (0.95,1.12),P=0.53],支架植入治疗贲门失弛缓症患者的术后2年症状缓解率优于球囊扩张治疗者[RR=0.77,95％ CI (0.64,0.92),P=0.005],但支架植入治疗贲门J失弛缓症患者的并发症发生率明显高于球囊扩张治疗者[RR=0.52,95％ CI (0.40,0.69),P＜0.000 01].结论 尽管本meta分析有诸多不足,但初步的研究结果显示,球囊扩张和支架植入治疗贲门失弛缓症在短期内均同等有效.从长期来看,支架植入治疗贲门失弛缓症较球囊扩张的效果更好,但只是会发生更多的并发症.因而在以后的临床诊疗过程中,要综合考虑疗效、风险及患者的身体状况和需求;在治疗过程中,应及时注意不良反应,做好充足准备,以减少并发症的发生,若当并发症发生时应及时采取措施对症治疗.“,”Objective To systematically evaluate efficacy and safety of endoscopic pneumatic dilation and endoscopic stent placement in treatment of achalasia.Methods Eligible studies comparing the pneumatic dilation and the stent placement in treatment of achalasia were identified by an electronic search of MedLine,Embase,ISI Web of Science,the Cochrane Database,China Biology Medicine and Wanfang databases from inception to December 2015.Two reviewers independently screened the literatures,extracted data,and assessed the risk of bias of included studies.Then,RevMan 5.3 software was used for meta-analysis.Results A total of 4 randomized controlled trials including 343 patients with achalasia (176 cases in the pneumatic dilation group,167 cases in the stent placement group) were subjected to the final analysis.The results of meta-analysis showed that the postoperative short term symptom relief rate had no significant difference between the pneumatic dilation group and the stent placement group [RR=1.03,95％ CI (0.95,1.12),P=0.53],the postoperative 2-year symptom relief rate of the stent placement group was significantly higher than that of the pneumatic dilation group [RR=0.77,95％ CI (0.64,0.92),P=0.005],but the complications rate of the stent placement group was significantly higher as compared with the pneumatic dilation group [RR=0.52,95％ CI (0.40,0.69),P＜0.000 01] too.Conclusions Although this meta-analysis has some shortcomings,preliminary results show that short term effects of pneumatic dilation and stent placement in treatment of achalasia are effective,long term effect of stent placement in treatment of achalasia is better as compared with pneumatic dilation,but it's complications rate is higher.So in clinical diagnosis and treatment,effect,risk,patient's physical condition,and demand should be considered together;during treatment,we should pay attention to adverse reactions and prepare adequately in order to reducing complications.When complications occur,we should take timely symptomatic treatment.