目的 评价内镜下注射肉毒毒素治疗贲门失弛缓的临床效果。方法 对 57例贲门失弛缓病人采用内镜下注射 A型肉毒毒素治疗，通过对治疗前后主要症状评分及食管下括约肌压力（ LESP）测定评价近期疗效。治疗后半年、 1年、 2年随访，评价中远期疗效。结果 在 57例病人中有 54例治疗后症状缓解占 95％，无合并症发生。随访观察治疗后半年以上有 41例，其中 36例未复发占 88％； 1年以上 30例，有 25例未复发占 83％； 2年以上 12例，有 8例未复发占 67％。结论 内镜下注射 A型肉毒毒素治疗贲门失弛缓是一简单、安全、有效的方法。 Objective To evaluate the clinical efficacy of endoscopic injection of botulinum toxin in the treatment of achalasia. Methods Fifty-seven patients with achalasia were treated by endoscopic injection of botulinum toxin type A, and the short-term efficacy was evaluated by the main symptom scores and the lower esophageal sphincter pressure (LESP) before and after treatment. Six months after treatment, 1 year, 2 years follow-up, evaluation of long-term efficacy. Results In 57 patients, 54 patients had 95% of symptom relief after treatment, and no complications occurred. Follow-up After treatment for more than six months, there were 41 cases, of which 36 cases did not recurrence accounted for 88%; 1 year or more in 30 cases, 25 cases of non-recurrence accounted for 83%; 2 years or more in 12 cases, 8 cases of 67%. Conclusion Endoscopic injection of botulinum toxin A is a simple, safe and effective method for the treatment of achalasia.