The Vale Of Improved Pneumatic Balloon Dilation In The Therapy Of Achalasia

Objective:1. Evaluating the clinical symptom and analysis the clinical effects of the improved balloon dilatation cures on the achalasia of cardia;2. Comparing the differences between the improved balloon dilatation cures and the traditional ways on treating the achalasia of cardia. Therefore, a judge of weather the improved balloon dilatation cures is effective on the achalasia of cardia will be given;3. The aim of this dissertation is to find a more suitable way to cure the achalasia of cardia in Shanxi Province with improved balloon dilatation cures. In addition, this dissertation presents the research results on the current endoscopic technique in the basic medical level of Shanxi province.Methods:This study collected and analyzed the data of 80 patients who suffered from the achalasia of cardia between January 2010 and December 2010. All patients have been told the potential benefits and risks. The patients also signed the informed consent form before the operations. The details of names, sexes, ages, course of diseases, contact details and preoperative symptoms were recorded to evaluate patients according to the endoscopic Ling classification. The dates of the first expansion and intraoperative complications were recorded in details, and the patients were informed to strengthen the treatment after the balloon expansion in the first 5-7 days. Some patients were cured after the second expansion on time, but some patients were not due to personal reasons. Among the 80 patients, only 41 of them strengthened treatment completely to expand the balloon diameter. However, the resets(i.e. 39) of them were treated just once or not treated. The doctors made phone calls follow-up to survey 2 groups of patients after treatment of 3 months, 6 months, 12 months and 24 months according to the standard scores of Parischa, and then, recorded the sores of clinical symptom for two groups before and after treatment in details. Finally, they analyzed the data and made conclusions using the statistical methods.Results:In this study of 80 patients with achalasia of cardia, 3 patients who were treated by modified balloon dilatation were not followed up for 12 months. The follow-up rate is 96.3% for 12 months. 41 patients were successfully received treatment using modified balloon dilatation. Serious complications, such as perforation and bleeding, are not occurred in the 80 patients. Some patients suffered from partial tear, ooze blood and chest pain in mucous membrane, but no special treatment was needed. The sores with modified balloon dilatation were significantly lower than that before treatment after 3, 6, 12, 24 months(P < 0.05). The effective rate of expansion after 3 months was 100.0%(41/41) and 92.7%(38/41) for 6 months. However, there are 3 cases showing poor effects. 2 of them(i.e. Ling Ⅱb, Ⅱc, 1 case of each) successfully expand treatment again, and the other 1 case(i.e. Ling type) received the surgical treatment in our hospital. There were Ⅲ3 patients lost follow-up after operations in 12 and 24 months, the expansion efficient were 86.8%(33/38) and 76.3%(29/38) respectively. Two groups of patients with achalasia of cardia had obvious and positive effects after treatment in the recent period(≤6 months), but there was no statistically significant difference. Long-term curative effects of two groups have statistical significance: traditional balloon expansion group after treatment for 3 months, 6 months, 1 year, 2 years, the efficiency is 97.4%, 74.4%, 61.5% and 23.1% respectively. It is lower than the efficiency of modified balloon expansion with the rates of 100%, 92.7%, 86.3% and 76.3% respectively.Conclusion:Related literatures report the curative effect of balloon expansion cures the achalasia of cardia on time is 66%, but the treatment’s effectiveness gradually declines as time goes by. Basic level hospitals used to cure achalasia of cardia in traditional ways while the modified balloon dilatation is a safer and more effective method to cure this illness through expanding the balloon diameter. This method not only reduces the risk of perforation caused by big balloon for the first time, but also reduces the recurrence of single balloon expansion effectively.