摘要
目的应用治疗前后症状评分差别和钡餐检查后存钡高度和宽度的差别,来评价气囊扩张治疗的有效率。分别比较钡餐检查后1分钟,5分钟的存钡高度和宽度与症状评分的相关性。分析年龄和性别因素对扩张治疗疗效的影响。方法选取从2005年到2009年的首次接受气囊扩张治疗的贲门失弛缓症患者63名,共接受3.2厘米的气囊扩张治疗90次。比较90次扩张治疗前后的症状评分、评分总分和钡餐检查后的1分钟、5分钟存钡高度、宽度的差异,评价治疗的效果。结果治疗前后,咽下困难、胸痛和反流症状评分和评分总分,及钡餐检查后1分钟存钡高度、存钡宽度和5分钟的存钡高度P值均小于0.005,差异有显著性,而5分钟的存钡宽度治疗前后无显著统计学意义(P=0.063)。显著的统计学差异也存在于钡餐检查后1分钟存钡高度与咽下困难评分(P﹤0.05,rho=0.47),胸痛评分(P<0.05,rho=0.42)和症状评分总分(P<0.05,rho=0.46)。但是钡餐检查后的1分钟的存钡宽度、5分钟的存钡高度及宽度和症状评分以及总分之间差异无明显统计学意义(P﹥0.05)。结论气囊扩张是治疗贲门失弛缓症的有效方法,治疗有效率随时间延长而减小。63名贲门失弛缓症患者随访5年的有效率为70%。症状评分与吞钡检查在评价气囊扩张治疗贲门失弛缓症中有显著的相关性,两者都可以评价扩张治疗的效果。
Objective： To evaluate the improvement of the patients undergoing pneumatic dilation by comparing pre and post dilation standardized symptoms score with barium height and barium width,to test the correlations between symptom scores and the height and the width of the barium column at 1 minute and 5 min after barium ingestion,and to analyze the impact of the gender and the age on the improvement of the treatment.Methods： A total of 63 patients with achalasia who were treated with pneumatic dilation between 2005 and 2009 were analyzed.They underwent 90 pneumatic dilations.All of the pneumatic dilations were performed with the 3.2cm balloon.Pre and post dilation symptom scores were recorded.Barium column height and width were measured 1 min and 5 min after ingesting a fixed volume of barium to assess oesophageal emptying.Results： There was significant difference（P﹤0.05） between pre-dilation patients symptoms scores（dysphagia,chest pain,regurgitation and total scores）,and 5 min barium height and post-dilation patients,but this difference could not be observed in the 5 min barium width between pre-dilation patients and post-dilation patients（P=0.063）.Significant correlations were found between the height of the barium column at 1 minute and the symptom scores for dysphagia（P0.05,rho=0.47）,chest pain（P0.05,rho=0.42） and the tatol scores（P0.05,rho=0.46） after dilation.However,there were no significant correlations（P﹥0.05） between the symptom scores and the height of the barium column at 1 min,the height and the width of the barium column at 5 min.In 73 of 90（81%） pneumatic dilations,the degree of symptom and barium height improvement was similar.Conclusion： Although pneumatic dilation is an effective primary treatment in patients with primary achalasia,patients are at risk of recurrent disease,with this risk increasing during long term follow-up.In this study,the improvement of the pneumatic dilation treatment for 63 patients is 70% after a 5-years follow-up.There is a significant association between patient symptoms and barium height improvements,both of which can be used to evaluate the improvement of the treatment.
出处
《泰山医学院学报》
CAS
2012年第7期499-502,共4页
Journal of Taishan Medical College
